Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Nov 30;15(12):581.
doi: 10.3390/jpm15120581.

Incisional Negative-Pressure Wound Therapy Versus Standard Dressing for the Prevention of Surgical Site Complications Following Radical Cystectomy

Fabio Traunero  1   2 , Arianna Biasatti  1 , Giulio Rossin  1 , Andrea Piasentin  1 , Federico Zorzi  1 , Michele Rizzo  1 , Paolo Umari  1 , Tommaso Cai  3 , Alessandro Zucchi  4 , Giovanni Liguori  1
Affiliations

Incisional Negative-Pressure Wound Therapy Versus Standard Dressing for the Prevention of Surgical Site Complications Following Radical Cystectomy

Fabio Traunero et al. J Pers Med. .

Abstract

Background/Objectives: Radical cystectomy (RC) is a complex urologic procedure that, when performed using an open surgical approach, carries a high risk of surgical site complications (SSCs), which can lead to prolonged recovery, increased healthcare costs, and higher morbidity. Incisional negative-pressure wound therapy (iNPWT) has demonstrated benefits in enhancing wound healing in various surgical settings, but its effectiveness in the context of RC remains underexplored. This study aimed to evaluate the impact of iNPWT on the incidence of SSCs following RC compared to standard surgical dressings using the PICO® system. Methods: A cohort of 146 patients who underwent RC between 2015 and 2021 was divided into two groups: those treated with standard dressings (Group 1, n = 80) and those who received iNPWT (Group 2, n = 66). Patient-related, surgical, and pathological variables were compared between the groups. Categorical variables were analyzed using the chi-square or Fisher's exact test, while continuous variables were assessed using Student's t-test. Univariate logistic regression models were applied to evaluate the association between iNPWT use and 90-day SSCs, as well as to identify risk factors for complications. Results: Group 2 (iNPWT) had a higher prevalence of chronic comorbidities, including chronic kidney disease, but fewer active smokers compared to Group 1. Higher body mass index, prolonged operative time, and uncontrolled diabetes were significantly associated with the development of SSCs. The incidence of SSCs within 90 days was significantly lower in the iNPWT group (7.6%) compared to the standard dressing group (22.5%) (p = 0.03). iNPWT use was associated with a substantially reduced risk of SSCs (OR: 0.282), demonstrating a protective effect. Conclusions: Prophylactic application of iNPWT following RC significantly reduced the incidence of surgical site complications compared to standard dressing. These findings support the potential of iNPWT as a valuable adjunct in perioperative wound management. While encouraging, these results warrant validation in prospective, randomized studies. Tailored postoperative strategies and identification of patient-specific risk factors remain essential components in SSC prevention and reflect the growing importance of precision medicine in surgical oncology.

Keywords: PICO® system; iNPWT; open surgery; radical cystectomy; surgical site complications.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
iNPWT dressing (PICO® system) after open radical cystectomy.
See this image and copyright information in PMC

References

    1. Abudurexiti M., Ma J., Li Y., Hu C., Cai Z., Wang Z., Jiang N. Clinical Outcomes and Prognosis Analysis of Younger Bladder Cancer Patients. Curr. Oncol. 2022;29:578–588. doi: 10.3390/curroncol29020052. - DOI - PMC - PubMed
    1. Alfred Witjes J., Max Bruins H., Carrión A., Cathomas R., Compérat E., Efstathiou J.A., Fietkau R., Gakis G., Lorch A., Martini A., et al. European Association of Urology Guidelines on Muscle-Invasive and Metastatic Bladder Cancer: Summary of the 2023 Guidelines. Eur. Urol. 2024;85:17–31. doi: 10.1016/j.eururo.2023.08.016. - DOI - PubMed
    1. Kim S.P., Shah N.D., Karnes R.J., Weight C.J., Frank I., Moriarty J.P., Han L.C., Borah B., Tollefson M.K., Boorjian S.A. The Implications of Hospital Acquired Adverse Events on Mortality, Length of Stay and Costs for Patients Undergoing Radical Cystectomy for Bladder Cancer. J. Urol. 2012;187:2011–2017. doi: 10.1016/j.juro.2012.01.077. - DOI - PubMed
    1. Takeyama K., Matsukawa M., Kunishima Y., Takahashi S., Hotta H., Nishiyama N., Tsukamoto T. Incidence of and Risk Factors for Surgical Site Infection in Patients with Radical Cystectomy with Urinary Diversion. J. Infect. Chemother. 2005;11:177–181. doi: 10.1007/s10156-005-0391-1. - DOI - PubMed
    1. Joice G.A., Tema G., Semerjian A., Gupta M., Bell M., Walker J., Kates M., Bivalacqua T.J. Evaluation of Incisional Negative Pressure Wound Therapy in the Prevention of Surgical Site Occurrences After Radical Cystectomy: A New Addition to Enhanced Recovery After Surgery Protocol. Eur. Urol. Focus. 2020;6:698–703. doi: 10.1016/j.euf.2019.09.016. - DOI - PubMed

LinkOut - more resources