Authors: (including presenting author): :
Pun MK(1), Chong HM(2), Chan PF(2), Poon CM Michael(2)
Affiliation: :
(1)Nursing Services Division, New Territories West Cluster, (2)Department of Surgery, New Territories West Cluster
Keyword 1: :
Wound Infection
Keyword 2: :
Surgical Site Infection
Keyword 3: :
incisional negative pressure wound therapy (iNPWT)
Keyword 4: :
Colorectal Surgery
Introduction: :
Surgical Site Infection (SSI) is a prevalent, costly complication in colorectal surgery, threatening patient recovery with prolonged hospital stays, higher readmissions, increased mortality, and heavy healthcare burdens. As colorectal procedures often involving anastomoses, exposure to gastrointestinal flora, and lengthy operative times, they carry inherently higher SSI risks than other surgeries. At Tuen Mun Hospital (TMH), SSI has long been a critical clinical challenge in elective colorectal surgery, with rates consistently exceeding regional benchmarks. A 10-year analysis (2014/15–2023/24, SOMIP 2024 report) shows TMH’s SSI rate remains persistently higher than the Hospital Authority (HA) mean. This gap highlights the urgent need for targeted interventions, and iNPWT, an evidence-based, feasible solution, may address TMH’s ongoing SSI issue.
Objectives: :
1. Reduce the incisional wound infection rate via consistent, evidence-based perioperative interventions. 2. Establish protocol-driven SSI prevention across the colorectal surgery perioperative pathway to minimize care variability linked to elevated infection risks. 3. Reduce SSI-related complications and enhance the safety and effectiveness of elective colorectal surgery at TMH.
Methodology: :
Following PRISMA systematic literature selection, 14 articles (5 systematic reviews, 6 RCTs, 3 observational studies) were analyzed, concluding that iNPWT reduces mean SSI rates by 63%. A pilot program evaluated iNPWT’s efficacy in lowering incisional wound infection for elective colorectal surgery at TMH. Non-probability consecutive sampling was used to recruit eligible patients during the study period (starting Oct 13, 2025) until reaching 150 participants. Surgeons applied disposable NPWT devices intraoperatively, the wound care team monitored the system and provided wound care, while colorectal nurses tracked compliance and SSI outcomes.
Result & Outcome: :
Between October 13 and January 5, 2025, 31 eligible patients (undergoing laparoscopic/open elective colorectal surgery at Tuen Mun Hospital) were recruited for the iNPWT pilot: 17 males (54.8%) and 14 females (45.2%), aged 33–85 (median 69.0). 38.7% had a stoma, 61.3% did not, and all procedures were minimally invasive. No mortality but one with wound dehiscence (3.2%) was reported; all complications stayed stable during acute postoperative monitoring. Statistically no difference between gender and presence of stoma in relation to incisional wound infection with the application of iNPWT. Though small, preliminary results align with literature, supporting increased sample size to validate iNPWT’s role in lowering TMH’s elevated SSI rates.
