Negative Pressure Wound Therapy in the Prevention of Surgical Site Infections Following Abdominal Surgery: A Systematic Review

Abstract

Negative pressure wound therapy (NPWT) has emerged as a promising intervention for reducing surgical site infections (SSIs) across various surgical disciplines, particularly in high-risk abdominal and gastrointestinal surgeries. This systematic review aimed to evaluate the efficacy of NPWT in preventing SSIs and improving postoperative outcomes in such procedures. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library, identifying 641 studies, of which 10 high-quality randomized controlled trials (RCTs) met the inclusion criteria. Studies included a range of abdominal procedures, including emergency laparotomies, colorectal cancer surgeries, and hepatopancreatobiliary interventions. Findings indicated that NPWT significantly reduced SSI rates in high-risk populations, particularly in contaminated and emergency abdominal surgeries, with reductions in seroma formation and wound dehiscence also observed. However, some studies reported no significant benefits in lower-risk procedures, highlighting the importance of appropriate patient selection. Quality assessment revealed moderate-to-high methodological quality, though common limitations included open-label designs and sample size variability. The results support the targeted use of NPWT in high-risk abdominal surgeries, though further large-scale, multicenter trials are needed to refine patient selection criteria and optimize clinical application.

Keywords: abdominal surgery; gastrointestinal surgery; negative pressure wound therapy; randomized controlled trials; surgical site infections; systematic review; wound healing.

Figure 1. The PRISMA flowchart of the study selection process.

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses, NPWT: negative pressure wound therapy.