Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Use of Negative Pressure Wound Therapy for At Risk Surgical Closures
Brief Summary: In this study, the investigators propose using negative pressure wound therapy (NPWT) to aid in wound healing along the lines of closure for lower extremity amputation and complex abdominal wounds. This study is designed to be a prospective, randomized clinical trial to evaluate the effectiveness of NPWT versus accepted standard surgical dressings on these wounds. Study participants will be randomized to one of the two treatment groups (NPWT vs. standard dressing) prior to surgery, and will be followed in the post operative period to monitor the effects on their surgical closures. The experimental group will consist of participants receiving NPWT and will have a Vacuum Assisted Closure (V.A.C., KCI inc.) device placed intra-op along the line of closure. The control group will receive a standard surgical dry sterile dressing. The surgical closures will be assessed after three days of treatment as well as the first outpatient post-op visit and any subsequent visits through the following 6 months. By doing so, the investigators hope to demonstrate the utility of NPWT on difficult, at risk surgical closures. Additionally, the investigators hope to show a difference in clinical outcome of incisions treated by NPWT over our current standard technique.

All patients in the principal and co-investigators practice who are scheduled to undergo lower extremity amputation or complex abdominal closure will be eligible for enrollment in this prospective randomized study. There are no exclusion criteria. Informed consent will be obtained pre-operatively. Data collection will include basic demographic data, disease history, past medical and social history as well key data relating to wound healing (infection, wound dehiscence or breakdown) and hospital course (length of stay, operative complications). The investigators will use simple statistical methods (ANOVA and chi-squared analysis) to compare surgical wound healing between the two populations. The only deviation from current standard of care in these populations includes utilizing a V.A.C. system on the closure line of the experimental group versus the standard dry sterile dressing.


Options:
A: Arm Label: Negative pressure dressing; Type: EXPERIMENTAL; Interventions: Device: Negative pressure dressing | Arm Label: Standard dressing; Type: ACTIVE_COMPARATOR; Interventions: Device: Standard wound dressing | Intervention Type: DEVICE; Name: Negative pressure dressing; Assigned to Arm(s): Negative pressure dressing | Intervention Type: DEVICE; Name: Standard wound dressing; Assigned to Arm(s): Standard dressing
B: Arm Label: Closed Incision Wound vacuum (Prevena); Type: EXPERIMENTAL; Interventions: Device: Closed incision wound vacuum (Prevena) | Arm Label: Routine Wound Care; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DEVICE; Name: Closed incision wound vacuum (Prevena); Assigned to Arm(s): Closed Incision Wound vacuum (Prevena)
C: Arm Label: Dry Dressing; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Negative Pressure Wound Therapy; Type: EXPERIMENTAL; Interventions: Device: V.A.C. by K.C.I. | Intervention Type: DEVICE; Name: V.A.C. by K.C.I.; Assigned to Arm(s): Negative Pressure Wound Therapy
D: Arm Label: Current Standard; Type: ACTIVE_COMPARATOR; Interventions: Device: Standard Tegaderm (3M Healthcare, St. Paul, MN) adhesive dressing | Arm Label: Negative Pressure Wound Therapy; Type: EXPERIMENTAL; Interventions: Device: Prevena (Negative Pressure Wound Therapy Device) | Intervention Type: DEVICE; Name: Prevena (Negative Pressure Wound Therapy Device); Assigned to Arm(s): Negative Pressure Wound Therapy | Intervention Type: DEVICE; Name: Standard Tegaderm (3M Healthcare, St. Paul, MN) adhesive dressing; Assigned to Arm(s): Current Standard

Answer: C