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More Patients to Receive Wound Vacs After Their Pancreatic Surgery

The following summary comes from Javed et al. and was recently published in the Annals of Surgery, the preeminent surgical journal, in June 2019.

https://journals.lww.com/annalsofsurgery/Fulltext/2019/06000/Negative_Pressure_Wound_Therapy_for_Surgical_site.7.aspx

Despite a substantial decreased in the mortality associated with the Whipple procedure, postoperative complications, albeit non-life-threatening are frequently observed. Surgical site infections are a common complication, and in the immediate postoperative period add morbidity and in the long run can impact long-term outcomes in patients with pancreatic cancer due to delays in receipt of systemic therapy after surgery. Simply put, a surgical site infection occurs when pathogens such as bacteria infect the incision site. In case of a surgical site infection, in the days following the surgery, the incision often becomes tender, swollen and red, and purulent discharge may be observed. Management of this complication can range from antibiotic administration to need for a reoperation, depending on its severity. Surgical site infections can prolong hospitalization, result in readmissions, and increase healthcare costs. Individuals considered “high risk” for surgical site infections are those who have either undergone preoperative stenting of the bile duct or received neoadjuvant chemotherapy, or both. In this population the rate of surgical site infections of over 30% has been reported. 

 

Given this knowledge, this study sought to evaluate the impact of negative pressure wound therapy (sometimes referred to as “wound vacs”) on the rate of this complication. The authors conducted a randomized controlled trial evaluating the benefit of using this device in high risk patients. Patients were randomly assigned to receive the device or a standard wound closure. The device consists of a foam dressing over the incision that is connected to vacuum suction via tubing and works by keeping the incision dry (less favorable for growth of pathogens). 

 

Over a one-year period, 123 high risk patients who underwent Whipple procedure were included in the study. Surgical site infection occurred in 9.7% (6/62) of patients who received the device and in 31.1% (19/61) of patients in the standard closure group (P = 0.003). The relative reduction in risk of developing surgical site infection was 68.8%. Furthermore, on cost analysis surgical site infections were found to independently increase the cost of hospitalization by approximately 23.8%.

The use of negative pressure wound therapy resulted in a significantly lower risk of SSIs. Incorporating this intervention in surgical practice can help reduce a complication that significantly increases postoperative morbidity and healthcare costs.

Take home points:

  1. Surgical site infections are common, especially in high risk patients following the Whipple procedure.
  2. Negative pressure wound therapy (or wound vacs) can lower the risk of surgical site infections in high risk patients by almost 70%.

 

 

 

 

 

Image- KCI Negative Pressure Wound Therapy dressing. Image credit: https://www.kci-medical.sg/SG-ENG/vactherapy

Nikki Mitchell Foundation Premieres PSA at Traler Park Show

On June 18, 2019, 300 guests arrived at the Franklin Theatre for a rare and sold-out performance from the Traler Park. Jamey Johnson, Lee Brice, Rob Hatch, Dallas Davidson, Jerrod Niemann and Randy Houser took the stage to share both their music and the stories behind it. Before the show kicked off, the audience was the first to preview the Nikki Mitchell Foundation’s public service announcement.

The PSA shares the experience of two pancreatic cancer patients and a caregiver. “It is imperative that we get resources into the hands, the minds and the laboratories of innovative researchers,” explained the caregiver during her speech prior to the Traler Park performance.

The foundation was able to raise close to $60,000 towards their mission of providing comfort and relief for those affected by pancreatic cancer, while raising awareness and searching for the cure.

 

 

Cancer Treatment Gift Guide

 

Want to do something for a loved one who’s undergoing chemotherapy but don’t know what to do, what to get, or even what to say? I recently struggled with these questions when a friend who lives out of state told me she has cancer and has been on chemo for the last few months. This is just the beginning for her, as she has multiple surgeries scheduled for when she recovers from the infusions.

I chose get well gifts tailored to combat the effects of chemo and make her more comfortable during the treatment. Since my friend has surgeries after chemo, I hoped some of the items could help in her recovery as well.

Gift ideas:

Robe and slippers – To wear when feeling sick after chemo or surgery. Robes with pockets can hold drains if the patient will have them.

Ginger candies or butterscotch – Both help combat dry mouth as well as the metallic taste chemo leaves in the mouth.

Peppermint tea, nausea drops or queasy pops – Most people are nauseous during and after chemotherapy.

Head scarves, beanies, hat – This one is obvious, but when chemo patients lose their hair, they are frequently cold. A pashmina wrap can double as a headscarf or shoulder wrap.

Ways to pass the time – Treatments can take up to 8 hours and can be very boring sitting in the same room for that long. Items like magazines, audiobooks, crosswords or playing cards can help pass the time and distract the patient. If the person is crafty or hands-on, think about an embroidery kit, knitting supplies or an adult coloring book with markers or colored pencils.

Notebooks and notepads – Many patients get “chemo brain” (see article about that here) and their memories are foggy and they become forgetful. Writing things down will help them remember and give them more control over their daily lives.

Eye mask, earplugs, neck pillow, blanket, socks, slippers – Feel comfortable and for naps in the chemo chair and block out other patients who make them uncomfortable (i.e. snorers).

Unscented lotions – Chemo can lead to dry and itchy skin. Choose unscented lotions and creams, as patients can be sensitive to smells.

What are your thoughts on gifts for cancer patients? We’d love to hear your ideas, so feel free to leave them in the comments section.