The Safety of Negative-Pressure Wound Therapy on Surgical Wounds: An Updated Meta-analysis of 17 Randomized Controlled Trials

Abstract

Objective: To assess whether negative-pressure wound therapy (NPWT) reduced complications such as wound infection, dehiscence, seroma/hematoma, skin necrosis/blistering, and bleeding compared with non-NPWT treatments.

Methods: This meta-analysis involved randomized clinical trials of NPWT compared with non-NPWT on surgical wound healing. The main outcome was surgical site infections; secondary outcomes were dehiscence, seroma/hematoma, skin necrosis/blistering, bleeding, and reoperation.

Main results: Seventeen randomized controlled trials met the inclusion criteria, reporting on 928 NPWT and 930 non-NPWT patients. Compared with non-NPWT, NPWT was not associated with a significant reduction in wound infection (relative risk, 0.96; 95% confidence interval, 0.74-1.24). The reduction in wound dehiscence, seroma/hematoma, skin necrosis/blistering, and bleeding in the NPWT group was significant compared with that in the non-NPWT groups. Significant heterogeneity was observed in seroma/hematoma and skin necrosis/blistering between the NPWT and non-NPWT groups. No publication bias was observed.

Conclusions: Compared with non-NPWT, NPWT significantly reduced the rates of dehiscence, seroma/hematoma, skin necrosis\blistering, and bleeding, but not surgical site infections.