Vacuum-assisted wound closure and liver transplantation: new perspective and challenges

  • Daniele DondossolaEmail author
  • Barbara Antonelli
  • Giorgio Rossi
Letter to the Editor

To the editor,

Deep and superficial surgical site infections (SSIs) are commonly diagnosed after liver transplantation (LT). Liver transplanted patients are peculiarly susceptible to infections due to their pre-LT disease and post-LT immunosuppression [1]. For this reason, SSIs are burdened by poorer post-LT results and increased LT-related costs [2]. Different strategies were explored to reduce SSIs incidence and their systemic complications.

Magistri et al. [3] recently published a paper that describes their series of negative pressure wound treatment (NPWT) in LT patients. The study reports three cases of deep and ten of superficial SSIs treated with NPWT over a 17-year period. They applied NPWT after wound infection, delayed wound healing, abdominal sepsis or compartment syndrome within a maximum duration of 3 weeks. Mean NPWT duration for superficial SSIs was 13.9 (3–21) days and 9.3 (8–10) days in deep SSI, while hospital stay was 42.6 (8–80) days and 62 (23–133) days,...


Vacuum-assisted wound closure Liver transplantation Surgical site infections Multidrug resistant 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Research involving human participants and/or animals

The study, involving human participants, have been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments. our institutional Ethical committee was informed about the study and the patients

Informed consent

All patient's signed an informed consent.


  1. 1.
    Gagliotti C, Morsillo F, Moro ML et al (2018) Infections in liver and lung transplant recipients: a national prospective cohort. Eur J Clin Microbiol Infect Dis. CrossRefPubMedGoogle Scholar
  2. 2.
    Mehrabi A, Fonouni H, Wente M, Sadeghi M, Eisenbach C, Encke J (2006) Wound complications following kidney and liver transplantation. Clin Transplant 20(sup17):97–110CrossRefGoogle Scholar
  3. 3.
    Magistri P, Olivieri T, Serra V et al (2019) Vacuum-assisted management of surgical site infections after liver transplantation: 15-year experience in a tertiary hepatobiliary center. Updates Surg 71(3):457–462. CrossRefPubMedGoogle Scholar
  4. 4.
    Dondossola D, Cavenago MSP, Antonelli B et al (2015) Negative pressure wound treatment of infections caused by extensively drug-resistant gram-negative bacteria after liver transplantation: two case reports. Transplant Proc 47(7):2145–2149. CrossRefPubMedGoogle Scholar
  5. 5.
    Berry PS, Rosenberger LH, Guidry CA et al (2019) Intraoperative versus extended antibiotic prophylaxis in liver transplant surgery: a randomized controlled pilot trial. Liver Transpl 25:1043–1053. CrossRefPubMedGoogle Scholar

Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  1. 1.General and Liver Transplant Surgery UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Department of Pathophysiology and TransplantationUniversità degli Studi of MilanMilanItaly

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