eP115 - The Use of Negative Pressure Wound Therapy in Reducing Closure Times for Stoma Reversal Wounds

Purpose/Background: Traditional management of stoma reversal sites involves standard packing changes. More recently, studies have been conducted investigating the role of negative pressure wound therapy (NPWT). Early studies have found that NPWT increases the rate of stoma reversal site closure. In these studies, NPWT was discontinued at discharge with standard packing changes until the wound closed fully by secondary intention. We hypothesized that continuing NPWT until wound closure would be associated with faster closure times rather than discontinuing it earlier or using standard dressing changes alone.Methods/Interventions: This is a retrospective single institution chart review. We identified patients who underwent colostomy or ileostomy reversal at our hospital from 2019-2022. The following variables were identified: demographics (age, sex, BMI), medical comorbidities, method of closure, usage of NPWT vs standard dressing change, and time to wound closure. Patients were excluded if they were lost to follow-up prior to wound closure. We performed a Wilcoxon test for all possible individual group comparisons.Results/Outcomes: We identified 125 patients who underwent stoma reversal. Patients who received standard dressing changes alone (SD) (n=54) had a mean closure time of 6.9 weeks, 95% confidence interval (CI) [5.8,7.9]. Those who had NPWT placed initially but discontinued at any point prior to wound closure (DC) (n=40) had a mean closure time of 6.4 weeks, 95% CI [5.6,7.3]. Patients who had NPWT continued until wound closure (WC) (n=31) had a mean closure time of 5.4 weeks, 95% CI [4.6,6.2]. The difference in closure time between SD and WC was statistically significant (p=0.049). There was no significant difference in closure time between SD and DC (p=0.374) or DC and WC (p=0.086).Conclusion/

Discussion: There was a statistically significant difference in wound closure time between the SD and WC groups of approximately 1.5 weeks. Although there was an observed decrease in wound closure time for all NPWT groups, those who had it removed earlier did not have a statistically significant decrease in closure time. NPWT was discontinued earlier for a number of different non-life-threatening reasons (i.e. rash, pain, insurance coverage). Our results would suggest that continuing NPWT throughout the wound closure process would benefit patients in reducing closure time while also requiring less home care visits. Potential drawbacks to our study are its retrospective nature and subjectivity of determination of wound closure. However, it provides a scaffold for future investigation of NPWT for stoma reversal sites.Figure 1.Bar graph showing time to stoma reversal site closure in weeks (SD=standard dressings alone, DC=NPWT discontinued prior to wound closure, WC=NPWT discontinued at time of wound closure).