Incisional negative pressure wound therapy for clean-contaminated wounds in abdominal surgery: a systematic review and meta-analysis of randomized controlled trials

Expert Rev Gastroenterol Hepatol. 2021 Nov;15(11):1309-1318. doi: 10.1080/17474124.2021.1967143. Epub 2021 Aug 18.

Abstract

Objective: The role of incisional negative-pressure wound therapy (iNPWT) in preventing surgical site infections (SSIs) in clean-contaminated abdominal wounds is still controversial. This meta-analysis was performed to evaluate whether the use of iNPWT could reduce SSIs and other complications in clean-contaminated abdominal surgery.

Methods: The authors searched PubMed, EMBASE, Cochrane library, and Web of Science from database inception to 23 January 2021 for randomized controlled trials (RCTs). They assessed the risk of bias using the Cochrane Collaboration risk of bias tool and conducted a meta-analysis using RevMan 5.4.

Results: Eleven RCTs, including 4112 patients, were analyzed, of which 2057 were treated with iNPWT and 2055 with standard dressings. The SSI rates (OR = 0.76, 95% CI = 0.61-0.94, P = 0.01), in patients undergoing an iNPWT intervention were significantly lower than those in patients receiving standard dressings. There was no statistically significant difference between the rates of incision dehiscence, seroma, and readmission between groups.

Conclusions: Application of iNPWT for clean-contaminated wounds in abdominal surgery reduced SSI rates but showed similar rates of wound dehiscence, seroma, and readmission compared with standard dressings.

Keywords: Negative-pressure wound therapy; clean-contaminated wounds; meta-analysis; randomized controlled trials; surgical site infection.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Video-Audio Media

MeSH terms

  • Abdomen / surgery*
  • Bandages
  • Humans
  • Negative-Pressure Wound Therapy*
  • Patient Readmission
  • Randomized Controlled Trials as Topic
  • Seroma / prevention & control
  • Surgical Wound Dehiscence / prevention & control
  • Surgical Wound Infection / prevention & control*
  • Wound Healing