Incisional Negative Pressure Wound Therapy After High-Risk Lower Extremity Fractures

Abstract

There have been no studies evaluating incisional NPWT as a prophylactic treatment to prevent infection and wound dehiscence of high-risk surgical incisions. Our data demonstrate that there is a decreased incidence of wound dehiscence and total infections after high-risk fractures when patients have NPWT applied to their surgical incisions after closure. There is also a strong trend for decreases in acute infections after NPWT. Based on our data in this multicenter prospective randomized clinical trial, NPWT should be considered for high-risk wounds after severe skeletal trauma.

Meta-analysis of negative-pressure wound therapy for closed surgical incisions

“…After removal of duplicates, 872 remained. Eighty‐three full‐text papers were retrieved for inspection, of which seven were RCTs33, 34, 35, 36, 37, 38, 39. A further six unpublished studies were identified through contact with manufacturers and by searching ClinicalTrials.gov.…”

“…Four studies33, 36, 37, including that of B. D. Crist et al . (personal communication), used an NPWT device (VAC®) and six34, 35, 38, 39, including those of S. Karlakki et al .…”

“…One study36 included both primary and delayed primary sutured incisions. In two studies33, 37 some of the patients had more than one wound treated with the intervention. Another study randomized by body part, treating each patient with both iNPWT and standard dressing (R. Galiano et al ., personal communication).…”

“…To obtain the missing information, the corresponding authors of the seven published papers were contacted. One study37 provided the information requested. One author36 did not respond to the request, but had corresponded with the authors of the Cochrane review22.…”

“…In general, randomization and allocation concealment were not described adequately. Blinding of outcome assessment was described adequately in two studies36, 37. Three studies35, 36, including that of B. D. Crist et al .…”