Surgical site infection outcomes of two different closed incision negative pressure therapy systems in cardiac surgery: Systematic review and meta‐analysis

Abstract

Closed incision negative pressure therapy (ciNPT) system use compared with standard of care dressings (SOC) on surgical site infection (SSI) in cardiac surgery was assessed. A systematic literature review was conducted. Risk ratios (RR) and random effects models were used to assess ciNPT with foam dressing (ciNPT‐F) or multilayer absorbent dressing (ciNPT‐MLA) versus SOC. Health economic models were developed to assess potential per patient cost savings. Eight studies were included in the ciNPT‐F analysis and four studies were included in the ciNPT‐MLA analysis. For ciNPT‐F, a significant reduction in SSI incidence was observed (RR: 0.507, 95% confidence interval [CI]: 0.362, 0.709; p < 0.001). High‐risk study analysis reported significant SSI reduction with ciNPT‐F use (RR: 0.390, 95% CI: 0.205, 0.741; p = 0.004). For ciNPT‐MLA, no significant difference in SSI rates were reported (RR: 0.672, 95% CI: 0.276, 1.635; p = 0.381). Health economic modelling estimated a per patient cost savings of $554 for all patients and $3242 for the high‐risk population with ciNPT‐F use. Health economic modelling suggests ciNPT‐F may provide a cost‐effective solution for sternotomy incision management. However, limited high‐quality literature exists. More high‐quality evidence is needed to fully assess the impact of ciNPT use following cardiac surgery.