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Review
. 2024 May 30:24:e33.
eCollection 2024.

Closed Incision Negative Pressure Therapy Versus Standard of Care Over Closed Abdominal Incisions in the Reduction of Surgical Site Complications: A Systematic Review and Meta-Analysis of Comparative Studies

Christopher Mantyh  1 , Ronald Silverman  2 , Ashley Collinsworth  3 , Christine Bongards  3 , Leah Griffin  3
Affiliations
Review

Closed Incision Negative Pressure Therapy Versus Standard of Care Over Closed Abdominal Incisions in the Reduction of Surgical Site Complications: A Systematic Review and Meta-Analysis of Comparative Studies

Christopher Mantyh et al. Eplasty. .

Abstract

Background: Surgical site complications (SSCs) pose a significant risk to patients, potentially leading to severe consequences or even loss of life. While previous research has shown that closed incision negative pressure therapy (ciNPT) can reduce wound complications in various surgical fields, its effectiveness in abdominal incisions remains uncertain. To address this gap, a systematic review and meta-analysis were conducted to assess the impact of ciNPT on postsurgical outcomes and health care utilization in patients undergoing open abdominal surgeries.

Methods: A systematic literature search using PubMed, EMBASE, and QUOSA was performed for publications written in English, comparing ciNPT with standard of care dressings for patients undergoing abdominal surgical procedures between January 2005 and August 2021. Characteristics of study participants, surgical procedures, dressings used, duration of treatment, postsurgical outcomes, and follow-up data were extracted. Meta-analyses were performed using random-effects models. Dichotomous outcomes were summarized using risk ratios and continuous outcomes were assessed using mean differences.

Results: The literature search identified 22 studies for inclusion in the analysis. Significant reductions in relative risk (RR) of SSC (RR: 0.568, P = .003), surgical site infection (SSI) (RR: 0.512, P < .001), superficial SSI (RR: 0.373, P < .001), deep SSI (RR: 0.368, P =.033), and dehiscence (RR: 0.581, P = .042) were associated with ciNPT use. ciNPT use was also associated with a reduced risk of readmission and a 2.6-day reduction in hospital length of stay (P < .001).

Conclusions: These findings indicate that use of ciNPT in patients undergoing open abdominal procedures can help reduce SSCs and associated hospital length of stay as well as readmissions.A previous version of this abstract was presented at the 2023 Conference of the European Wound Management Association (EWMA) in Milan, Italy and posted online at the site listed below. EWMA permits abstracts to be republished with the complete manuscript. https://journals.cambridgemedia.com.au/application/files/9116/8920/7316/JWM_Abstracts_LR.pdf.

Keywords: Abdominal Surgery; Negative Pressure Wound Therapy; Surgical Site Complications; Surgical Site Infection.

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Figures

Figure 1
Figure 1
Study population inclusion and exclusion criteria.
Figure 2
Figure 2
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on risk of surgical site complication.
Figure 3
Figure 3
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on risk of surgical site infection.
Figure 4
Figure 4
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on risk of superficial surgical site infection.
Figure 5
Figure 5
Forest plot of the effect of ciNPT Over Closed Abdominal Surgical Incisions on Risk of Deep Surgical Site Infection
Figure 6
Figure 6
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on risk of dehiscence.
Figure 7
Figure 7
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on risk of of seroma.
Figure 8
Figure 8
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on risk off hematoma.
Figure 9
Figure 9
Forest plot of the effect of ciNPT over closed abdominal surgical incisions on readmissions.
Figure 10
Figure 10
orest plot of the effect of ciNPT over closed abdominal surgical incisions on length of stay.
See this image and copyright information in PMC

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