Evidence map›Paper›PMID 39542937›Full record

ArticleNeurosurgical review2024

Prophylactic closed-incisional negative pressure wound therapy following posterior instrumented spinal fusion: a single surgeon's experience and cost-benefit analysis.

Dallas E Kramer, Rosh Bharthi, Daniel Myers, Patrick Chang, Rocco Dabecco, Chen Xu, Alexander Yu

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In one paragraph

Article in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dallas E KramerDepartment of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, 15212, USA.
Rosh BharthiLake Erie College of Osteopathic Medicine, Erie, PA, 16509, USA.
Daniel MyersDepartment of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, 15212, USA.
Patrick ChangDrexel University College of Medicine, Philadelphia, PA, 19129, USA.
Rocco DabeccoDepartment of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, 15212, USA.
Chen XuDepartment of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, 15212, USA.
Alexander YuDepartment of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, 15212, USA. alexander.yu@ahn.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical site infections (SSIs) following spine surgery are associated with morbidity and resource utilization. Applying prophylactic closed-incisional negative pressure wound therapy (ciNPWT) during posterior instrumented fusion has mixed results in reducing rates of wound complications and SSI. We evaluated the clinical efficacy and potential cost-savings associated with ciNPWT in high-risk patients receiving posterior instrumented spinal fusion.

methodsWe retrospectively reviewed patients receiving posterior instrumented spinal fusion for any surgical indication between July 1, 2017 and December 31, 2019, and compared rates of wound dehiscence, SSI, and reoperation for wound complications between standard surgical dressings and ciNPWT. Surgical dressing selection was based on the senior author's assessment of infection risk factors.

resultsA total of 229 patients (n = 85 standard surgical dressings, n = 144 ciNPWT) were included. The ciNPWT group had significantly more risk factors for wound-related complications, including older age (61.8 vs. 58.5 years, p = 0.042), diabetes mellitus (36.8% vs. 23.5%, p = 0.037), more instrumented levels (5.6 vs. 3.9, p < 0.0001), estimated blood loss (1298 vs. 998 mL, p = 0.036), and deformity was the predominant operative indication (29.9% vs. 17.7%, p = 0.040). Prophylactic ciNPWT was associated with significantly lower rates of wound dehiscence (21.5% vs. 34.1%, p = 0.036) and SSI (8.3% vs. 21.2%, p = 0.005). Number needed to treat with ciNPWT to prevent one SSI was 8 patients. The cost of preventing one SSI was $4,560. Cost-benefit analysis demonstrated a potential mean savings of $21,662 per operative SSI prevented and $270,775 per 100 patients undergoing posterior instrumented fusion with ciNPWT.

conclusionsProphylactic ciNPWT use is a cost-effective means of reducing rates of wound dehiscence and SSI following posterior instrumented fusion.

Indexed as

Cost-Benefit AnalysisNegative-Pressure Wound TherapySpinal FusionSurgical Wound InfectionAdultAgedFemaleHumansMaleMiddle AgedReoperationRetrospective StudiesRisk FactorsSurgical Wound DehiscenceCost-benefit analysisNegative pressure wound therapySpinal fusionSurgical site infectionVacuum-assisted closure

Identifiers

PMID39542937
PMCPMC11564409

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.