Closed Incision Negative-Pressure Therapy Is Associated with Decreased Surgical-Site Infections

Abstract

The results of this meta-analysis suggest that closed incision negative-pressure therapy is a potentially effective method for reducing surgical-site infections. It also appears that closed incision negative-pressure therapy may be associated with a decreased incidence of dehiscence, but the published data available were too heterogeneous to perform meta-analysis.

Evaluation of inguinal vascular surgical scars treated with closed incisional negative pressure wound therapy using three‐dimensional digital imaging—A randomized controlled trial on bilateral incisions

“…3 In a randomized controlled trial (RCT), iNPWT on primary closed defects after superficial circumflex iliac artery perforator flap harvest reduced the amount of fluid collected by closed suction drains, allowing earlier removal of drains and enhanced the skin perfusion on the repaired skin. 4 Two systematic reviews with meta-analysis 5,6 on NPWT over closed surgical incisions suggests that iNPWT reduces surgical site infection (SSI) rates 5,6 and also seroma fromation 6 Increased inflammation is associated with prolonged wound healing and one report showed that iNPWT reduced the volume of postsurgically inflamed tissue adjacent to the surgical wound. 7 Similarly, mechanical tension over the wound bed induces increased inflammation and fibrotic healing.…”

“…In a randomized controlled trial (RCT), iNPWT on primary closed defects after superficial circumflex iliac artery perforator flap harvest reduced the amount of fluid collected by closed suction drains, allowing earlier removal of drains and enhanced the skin perfusion on the repaired skin . Two systematic reviews with meta‐analysis on NPWT over closed surgical incisions suggests that iNPWT reduces surgical site infection (SSI) rates and also seroma fromation but not wound dehiscence. To date, there are, however, no RCTs on vascular surgical patients and no study has evaluated the long‐term effects of iNPWT upon scarring, a surrogate marker for wound healing.…”

Prophylactic closed‐incision negative‐pressure wound therapy is associated with decreased surgical site infection in high‐risk colorectal surgery laparotomy wounds

“…These estimates accord with the findings of Hyldig and colleagues, who demonstrated a NNT of 25 patients (95% CI 17–93) . Patient selection for this intervention is highlighted by the meta‐analysis performed by Semsarzadeh et al ., which demonstrated a 29.4% relative risk reduction yet only a 2.75% absolute risk reduction . This suggests that it is important to utilize CINPT in patients at high risk for SSI in order to maximize cost benefits.…”

Closed incision prophylactic negative pressure wound therapy in patients undergoing major complex abdominal wall repair

“…Hence, the discrepancy of their results with our findings may well be explained by the striking differences in included patient population. Recently, for all types of surgery a systematic review and meta-analysis on pNPWT has been performed [23]. An overall weighted average SSI rate of 6.61% in the pNPWT groups was found compared with 9.36% in the control groups, reflecting a relative reduction of 29.4%.…”