Closed Incisional Negative Pressure Wound Therapy (ciNPWT) in Oncological Orthopedic Surgery: Preliminary Report

Abstract

This report presents the authors’ experience with surgical wound-healing using a negative-pressure wound therapy (NPWT) device in a population of oncological orthopedic patients. Two groups of 26 oncological patients each underwent surgical excision. After surgery, the control group received standard dressings and the closed incisional NPWT (ciNPWT) group was treated with a ciNPWT system on the sutured wound area for 14 days. As a primary endpoint, the percentage of post-surgery wound-site complications using ciNPWT devices was compared to that with standard patch dressings. Overall, 30.7% of the control group and 7.7% of the ciNPWT group manifested wound-site complications within 2 weeks after surgery. As a secondary endpoint, final wound healing was compared between the groups: delayed wound healing was observed in 4 (15.4%) patients in the control group and in none (0%) of those in the ciNPWT group. Finally, the length of stay (LOS) was 6.3 days in the control group and 5.1 days in the ciNPWT group. These results suggest that the ciNPWT device could be beneficial in minimizing the incidence of short-term surgical-site complications and decreasing length of stay in high-risk patients, such as those undergoing oncological orthopedic surgery.

Incisional negative pressure wound therapy for the prevention of surgical site infection: an up-to-date meta-analysis and trial sequential analysis

“…The most recent Cochrane Review from 2022 included 44 RCTs with 11,403 patients in the meta-analysis for primary outcome SSI. 10 Current meta-analysis additionally included 23 RCTs 33 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 for SSI that were not included in the Cochrane Review. 10 We made different methodological choices resulting in the exclusion of ten RCTs 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 that were included by the Cochrane Review.…”

“… 10 We made different methodological choices resulting in the exclusion of ten RCTs 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 that were included by the Cochrane Review. 10 Eighteen RCTs 33 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 50 , 52 , 53 , 54 , 55 , 57 were not yet included in any of the previous published meta-analyses ( Appendix 2 ). Meta-analysis showed a reduction of SSI rate with iNPWT compared with standard dressings (RR 0.67; 95% CI: 0.59–0.76, Fig.…”

“…We listed a detailed Risk of Bias assessment in Appendix 11 . There were seven RCTs at high risk of bias, 32 , 44 , 47 , 57 , 76 , 77 , 78 43 had some concerns regarding bias 25 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 43 , 45 , 46 , 48 , 50 , 52 , 54 , 56 , 58 , 69 , 70 , 71 , 73 , 74 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 and ten had low risk of bias. 31 , 33 , 41 , 49 , 51 , 53 , 55 , 72 , 99 , 100 …”