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

Groenen, Hannah; Jalalzadeh, Hasti; Buis, Dennis R.; Dreissen, Yasmine E. M.; Goosen, Jon H. M.; Griekspoor, Mitchel; Harmsen, Wouter J; IJpma, Frank F. A.; Laan, Maarten J. van der; Schaad, Roald  R.; Segers, Patrique; Zwet, W.C. van der; Jonge, Stijn De; Orsini, R.G.; Wolfhagen, Niels; Boermeester, Marja A.

doi:10.1016/j.eclinm.2023.102105

Cited by 4 publications

(1 citation statement)

References 103 publications

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“…Randomized clinical trials of negative pressure wound therapy after primary closure of surgical incisions for the prevention of SSIs have shown effectiveness for the prevention of SSIs across various emergency and elective procedures. The overall weight of evidence has gradually shifted in favor of this technique in updates to high-profile meta-analyses and is now supported by expert recommendation in the US . Although significant heterogeneity exists among studies (even those performed among similar populations), it appears likely that routine use of negative pressure wound therapy will ultimately be favored for some high-risk patient and procedure groups.…”

Section: Discussion and Observationsmentioning

confidence: 99%

Preventing Surgical Site Infections in the Era of Escalating Antibiotic Resistance and Antibiotic Stewardship

Long,

Cifu,

Salipante

et al. 2024

JAMA Surg

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ImportanceAccording to the Centers for Disease Control and Prevention and governing bodies within the American College of Surgeons, the administration of antibiotics as prophylaxis against infection prior to a planned elective procedure is, with rare exception, routinely recommended. The goal of “getting to zero” infections remains a high priority for policymakers, practitioners, and certainly for patients.ObservationsDespite the many advances in surgical technique, skin decontamination, sterile procedure, and enhanced recovery programs, surgical site infections continue to adversely affect procedures as diverse as dental implant surgery, joint arthroplasty, and major abdominal surgery. Although surgical site infection rates are at historically low levels, progress has stalled in recent reporting periods and such infections remain disabling, costly, and occasionally lethal. Stakeholders in the field, including surgeons, infectious diseases specialists, and industry, advocate for strategies emphasizing greater levels of intraoperative sterility or broader-spectrum antibiotic coverage as the most appropriate path forward.Conclusions and RelevanceThe current emphasis on ever-increasing levels of intraoperative sterility and extended-spectrum antibiotic use are not sustainable long-term solutions. Continuing to escalate these approaches may contribute to unintended consequences including antimicrobial resistance. Principles of antimicrobial stewardship and microbiome sciences can be applied to inform a more effective and sustainable approach to infection prevention in the field of surgery.

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Section: Discussion and Observationsmentioning

confidence: 99%