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The results of the WHIST trial are in!

WHIST

Incisional negative-pressure wound therapy does not provide a benefit compared to standard wound dressings for surgical incisions associated with major trauma to the lower limbs.

Major trauma is the leading cause of death worldwide in people under 45 and a significant cause of short- and long-term disability. In the context of major trauma, the wounds associated with surgery to fractured limbs are notoriously difficult to manage and serious wound healing complications such as deep surgical site infection (SSI) are common.

The WHIST trial investigated whether the type of dressing applied over the wound at the end of the operation can reduce the rate of infection. However, no significant difference in rate of infection between Negative Pressure Wound Therapy (NPWT) and standard dressing was identified.

WHIST was a randomised, controlled, superiority trial which randomised 1548 participants to either NPWT or standard wound dressing in a 1:1 ratio. Rates of deep SSI at 30 days post-randomisation were similar for both treatments (6.7% in the standard dressing group vs. 5.8% in the NPWT group) and there was no statistically significant difference between the groups (risk difference -0.8%; 95% CI -3.2% to 1.7%). There was also no significant difference between the two groups in terms of disability, quality of life or scar appearance at 3 or 6 months post-randomisation.

 

The monograph publication for the WHIST trial can be found here.