ABSTRACT
Introduction:
Wound complications can cause considerable
morbidity in
kidney transplantation. Closed-incision
negative pressure wound therapy (ciNPWT) systems have been efficacious in reducing
wound complications across
surgical specialties. The aims of this study were to evaluate the use of ciNPWT, Prevena™, in
kidney transplant recipients and to determine any
association with
wound complications. Material and
methods:
A single-center, prospective observational
cohort study was performed in 2018. A total of 30 consecutive
kidney transplant recipients deemed at high
risk for
wound complications received ciNPWT, and the results were compared to those of a historical cohort of subjects
who received conventional
dressings.
Analysis for recipients with
obesity and
propensity score matching were performed.
Results:
In total, 127 subjects were included in the
analysis. Of these, 30 received a ciNPWT
dressing and were compared with 97 subjects from a non-study historical
control group who had conventional
dressing. The overall
wound complication rate was 21.3% (27/127). There was no reduction in the rate of
wound complications with ciNPWT when compared with conventional
dressing [23.3% (7/30) and 20.6% (20/97), respectively, p = 0.75]. In the obese subset (BMI ≥30 kg/m2), there was no significant reduction in
wound complications [31.1% (5/16) and 36.8% (7/19), respectively, p = 0.73].
Propensity score matching yielded 26 matched pairs with equivalent rates of
wound complications (23.1%, 6/26).
Conclusion:
This is the first reported
cohort study evaluating the use of ciNPWT in
kidney transplantation. While ciNPWT is safe and well tolerated, it is not associated with a statistically significant reduction in
wound complications when compared to conventional
dressing. The findings from this study
will be used to inform
future studies associated with ciNPWT in
kidney transplantation.
