Safety and efficacy of negative pressure wound therapy in treating deep surgical site infection after lumbar surgery

The present meta‐analysis was conducted to comprehensively assess the impact of closed‐incision negative‐pressure wound therapy (ciNPWT) on the incidence of surgical site infections (SSIs) in patients undergoing spinal fusion surgery, thereby aiming to provide evidence‐based support for the prevention of postoperative wound infections during spinal surgery. Relevant studies pertaining to the application of ciNPWT in spinal surgery were retrieved through searches of the PubMed, Embase, MEDLINE and Cochrane Library databases, spanning from their inception to May 2023. The literature screening and data extraction were performed by two researchers based on predefined inclusion and exclusion criteria, followed by a quality assessment of the included studies. Meta‐analyses were performed using the odds ratios (ORs) and standardised mean differences (SMDs) as effect variables. RevMan 14.0 and STATA 17.0 were employed for meta‐analysis of the extracted data. In total, eight articles involving 1198 patients, including 391 in the experimental group and 807 in the control group, were included. The meta‐analysis results revealed that ciNPWT significantly reduced the incidence of SSIs in patients undergoing spinal fusion surgery (OR, 0.39; 95% CI: 0.22–0.67, p = 0.0007); however, it did not lead to a reduction in hospital stay duration (SMD: −0.48, 95% CI: −0.98 to 0.01, p = 0.06). Existing evidence suggests that ciNPWT has a positive impact on patients undergoing spinal fusion surgery, as it significantly reduces the incidence of postoperative surgical site wound infections; however, it does not result in a shorter hospital stay for patients.

Section: Resultsmentioning

confidence: 99%

“…Finally, eight articles were included in the analysis. [13][14][15][16][17][18][19][20] The basic characteristics of the included studies are presented in Table 1.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

Influence of closed‐incision negative‐pressure wound therapy on the incidence of surgical site wound infection in patients undergoing spine surgery: A meta‐analysis

Liu

Tian

2023

“…In total, 48 studies that did not meet the inclusion criteria were excluded by careful reading of the full text. Finally, 10 studies, totalling 1448 patients, were included in the meta‐analysis 17,19–27 . Basic characteristics of the included studies are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, 10 studies, totalling 1448 patients, were included in the meta-analysis. 17,[19][20][21][22][23][24][25][26][27] Basic characteristics of the included studies are shown in Table 1.…”

Section: Study Selectionmentioning

confidence: 99%

The impact of negative pressure wound therapy on surgical wound infection, hospital stay and postoperative complications after spinal surgery: A meta‐analysis

Lu,

Yuan,

et al. 2023

To systematically assess the effect of negative pressure wound therapy (NPWT) on postoperative surgical wound infection, length of hospital stay and postoperative complications after spinal surgery. Relevant studies on the application of NPWT in spinal surgery were conducted via a computerised database search, including PubMed, EMBASE, Web of Science, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang, from inception to June 2023. The identified literature was rigorously screened and data extraction was performed by two investigators independently. The quality of the relevant studies was evaluated using the Newcastle–Ottawa scale (NOS). The effect size for count data was determined by the odds ratio (OR), while the impact size for measurement data was expressed as the standardised mean difference (SMD). The 95% confidence interval (CI) was calculated for each effect magnitude. Stata 17.0 software was used for the meta‐analysis. Ten papers, totalling 1448 patients, were finally included. This study demonstrated that NPWT led to a statistically significant reduction in the occurrence of postoperative surgical wound infections (OR: 0.377, 95% CI: 0.238–0.598, p < 0.001), fewer postoperative complications (OR: 0.526, 95% CI: 0.360–0.770, p = 0.001) and a shortened hospital stay (SMD: −0.678, 95%CI: −1.324 to −0.031, p = 0.040) after spinal surgery compared with the control group. When compared with other treatment approaches, NPWT also demonstrated a substantial reduction in surgical wound infections and postoperative complications, as well as a shorter duration of hospitalisation after spinal surgery.

“…[32][33][34] With advancements in modern medical technology and continuous improvement in treatment methods, negativepressure wound therapy (NPWT) has been increasingly employed across surgical departments. Its long-term clinical practice has proven significant in treating postoperative infections of various surgical types, 35,36 providing essential support in hastening patient recovery. NPWT is a novel treatment modality that has evolved in recent years, differing from traditional wound debridement and negative-pressure drainage.…”

Section: Discussionmentioning

confidence: 99%

Effects of negative‐pressure wound therapy in the prevention of surgical‐site wound infection after vascular surgery: A meta‐analysis

Yu,

Xie,

et al. 2024

This meta‐analysis systematically evaluates the impact of negative‐pressure wound therapy (NPWT) on surgical‐site wound infection after vascular surgery. A comprehensive computerized search was conducted, from database inception to November 2023, in PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases for randomized controlled trials (RCTs) on the application of NPWT in vascular surgery. Two researchers independently screened the literature, extracted data, and conducted quality assessments based on inclusion and exclusion criteria. Data analysis was performed using RevMan 5.4 software. A total of 11 RCTs involving 1597 vascular surgery patients were included. The analysis revealed that the application of NPWT in vascular surgery significantly reduced the incidence of wound infections (OR = 0.43, 95% CI: 0.32–0.58, p < 0.001) and complications (OR = 0.40, 95% CI: 0.27–0.58, p < 0.001). Additionally, NPWT was found to decrease the occurrence of both superficial wound infections (OR = 0.63, 95% CI: 0.36–1.12, p = 0.12) and deep wound infections (OR = 0.47, 95% CI: 0.19–1.16, p = 0.10), although these differences were not statistically significant. This study indicates that NPWT, compared with conventional treatment methods, has significant advantages in preventing postoperative wound infections and complications in vascular surgery patients and is therefore worthy of widespread clinical adoption.