Effectiveness of Incisional Negative Pressure Wound Therapy in the Prevention of Post-Amputation Complications: Systematic Review and Meta-Analysis

Abstract

Background: Negative pressure wound therapy (NPWT) is an advanced therapy utilizing sub-atmospheric pressure at the wound site to generate a controlled environment that promotes blood flow and stabilizes the wound area. However, its effectiveness in diminishing surgical site complications remains unproven effectively. We aim to assess the impact of incisional NPWT (iNPWT) on the reduction of surgical wound complications, mortality rate, and improvement of healing rate following lower limb amputation.

Methods: An extensive search was executed in several databases for relevant studies evaluating iNPWT following lower limb amputation. We used RevMan to calculate pooled risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes with 95% confidence interval (95% CI). The outcomes of our analysis were the assessment of overall post-intervention wound complications, surgical site infection, need for revision surgery, seroma or hematoma formation, 30-day mortality, subsequent amputation, readmission, and the time taken for complete healing.

Results: Ten studies, including a total of 1,003 patients, were included in our analysis. The findings indicate a significant reduction in the risk of overall post-intervention wound complications (RR, 0.41; 95% CI 0.20, 0.84) and a shorter time to complete healing (MD, -1.76 weeks; 95% CI -2.66, -0.86 weeks) compared to the control group. No significant difference was found in wound infection, seroma or hematoma formation, readmission, and mortality rates between the iNPWT and the control groups.

Conclusion: iNPWT significantly reduces overall post-intervention wound complications and shortens the time required for complete healing.