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Meta-Analysis
. 2021 Jan;29(1):8-19.
doi: 10.1111/wrr.12858. Epub 2020 Aug 21.

A systematic review evaluating the influence of incisional Negative Pressure Wound Therapy on scarring

Pieter R Zwanenburg  1 , Floyd W Timmermans  2 , Allard S Timmer  1 , Esther Middelkoop  2   3 , Berend T Tol  1 , Oren Lapid  4 , Miryam C Obdeijn  4 , Sarah L Gans  1 , Marja A Boermeester  1
Affiliations
Meta-Analysis

A systematic review evaluating the influence of incisional Negative Pressure Wound Therapy on scarring

Pieter R Zwanenburg et al. Wound Repair Regen. 2021 Jan.

Abstract

Pathological scars can result in functional impairment, disfigurement, a psychological burden, itch, and even chronic pain. We conducted a systematic review to investigate the influence of incisional Negative Pressure Wound Therapy (iNPWT) on scarring. PubMed, EMBASE and CINAHL were searched for preclinical and clinical comparative studies that investigated the influence of iNPWT on scarring-related outcomes. Individual studies were assessed using the OHAT Risk of Bias Rating Tool for Human and Animal studies. The body of evidence was rated using OHAT methodology. Six preclinical studies and nine clinical studies (377 patients) were identified. Preclinical studies suggested that iNPWT reduced lateral tension on incisions, increased wound strength, and reduced scar width upon histological assessment. Two clinical studies reported improved patient-reported scar satisfaction as measured with the PSAS (1 year after surgery), POSAS, and a VAS (both 42, 90, and 180 days after surgery). Five clinical studies reported improved observer-reported scar satisfaction as measured with the VSS, SBSES, OSAS, MSS, VAS, and POSAS (7, 15, 30, 42, 90, 180, and 365 days after surgery). Three clinical studies did not detect significant differences at any point in time (POSAS, VAS, and NRS). Because of imprecision concerns, a moderate level of evidence was identified using OHAT methodology. Preclinical as well as clinical evidence indicates a beneficial influence of iNPWT on scarring. Moderate level evidence indicates that iNPWT decreases scar width and improves patient and observer-reported scar satisfaction.

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Conflict of interest statement

M.A. Boermeester reports institutional grants from J&J/Ethicon, Acelity/KCI, Allergan/LifeCell, Ipsen, Mylan, and is advisory board member of J&J/Ethicon, 3M/KCI, Bard. M.A. Boermeester is also speaker and/or instructor for 3M/KCI, Allergan/LifeCell, Bard Davol BD, Johnson&Johnson/Ethicon, Gore, and Smith & Nephew. E. Middelkoop reports institutional grants from Elastagen Pty Ltd, Micreos BV, Cutiss AG for research outside of the submitted work. O. Lapid is a speaker for Smith & Nephew. P.R. Zwanenburg is a speaker for GD Medical Pharma BV and Hospithera NV. The other authors do not declare any conflicts of interest. Please note that 3M, KCI, Smith & Nephew, GD Medical Pharma, and Hospithera NV are companies involved in the production or distribution of iNPWT technology.

Figures

FIGURE 1
FIGURE 1
Systematic review flow diagram
FIGURE 2
FIGURE 2
Office of health assessment and translation risk of bias tool assessment [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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