The The impact of a muscle pump activator on incisional wound healing compared to standard stockings and compression devices in kidney and kidney-pancreas transplant recipients: A randomized controlled trial

  • Shahid Aquil University Hospital, London Health Sciences Centre
  • Hemant Sharma Multi-Organ Transplant Program, London Health Sciences Center, Canada
  • Bijad Alharbi Multi-Organ Transplant Program, London Health Sciences Center, Canada
  • Katharine Pacoli Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center
  • Patrick P. Luke Multi-Organ Transplant Program, London Health Sciences Center, Canada
  • Alp Sener Multi-Organ Transplant Program, London Health Sciences Center, Canada
Keywords: kidney and kidney-pancreas transplant, muscle pump activator, incisional wound healing

Abstract

Introduction: We aimed to evaluate the impact of thrombo-embolic-deterrent + intermittent pneumatic compression (TED + IPC) vs. muscle pump activator (MPA) on incisional wound healing in kidney and simultaneous pancreas- kidney (SPK) transplant recipients.

Methods: We conducted a single-centre, randomized controlled trial in which 104 patients (kidney n=94; SPK n=10) were randomly assigned to wear TED + IPC (n= 52) or MPA (n=52) for the first six days following surgery. Patient demographics, postoperative outcomes, and incisional wound images were taken using a HIPAA-compliant application on postoperative days (POD) 3, 5, and 30, and assessed using the validated Southampton Wound Care Score.

Results: There were no demographic differences between the groups. The MPA group had a significant improvement in wound healing on POD 3 (p=0.04) that persisted until POD 5 (p=0.0003). At POD 30, both groups were similar in wound healing outcomes (p=0.51). Bayesian inferential analysis revealed that the use of TED + IPC following transplantation had inferior outcomes compared to the use of MPA with sequential moderate evidence. The rate of complex wound infections was significantly greater in the TED + IPC group compared to the MPA group (29% vs. 12%, respectively; p=0.03). Patients were more satisfied with the use of a MPA device than TED + IPC. No major complications were encountered in either group.

Conclusions: The use of a MPA device in the immediate postoperative period leads to a significant improvement in immediate and early wound healing, and decreased number of complex wound infections following kidney and SPK transplantation compared to standard TED + IPC therapy. Patients were more satisfied with the use of a MPA device than TED + IPC.

Published
2019-01-24
How to Cite
Aquil, S., Sharma, H., Alharbi, B., Pacoli, K., Luke, P. P., & Sener, A. (2019). The The impact of a muscle pump activator on incisional wound healing compared to standard stockings and compression devices in kidney and kidney-pancreas transplant recipients: A randomized controlled trial. Canadian Urological Association Journal, 13(11). https://doi.org/10.5489/cuaj.5822
Section
Original Research