Incisional Negative Pressure Wound Therapy for Prevention of Surgical Site Infection: A Systematic Review and Meta-Analysis.
Shaan Patel, Shiva A Nischal, Kush M Kale et al.
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In 30 seconds
This systematic review and meta-analysis pooled 85 randomised clinical trials involving 16,980 adults with primarily closed surgical incisions to compare incisional negative pressure wound therapy (iNPWT) with standard dressings. iNPWT was associated with a lower risk of overall surgical site infection (RR, 0.64; 95% CI, 0.57-0.72), as well as lower risks of several other wound complications. However, skin blistering and device-related adverse events were more frequent. The authors report moderate certainty of evidence and conclude that the findings support selective rather than routine use.
Key findings
- Overall SSI risk was lower with iNPWT than standard dressing (RR, 0.64; 95% CI, 0.57-0.72).
- Deep and superficial SSI risks were lower with iNPWT (RR, 0.66; 95% CI, 0.51-0.86; and RR, 0.59; 95% CI, 0.49-0.72, respectively).
- Skin blistering was more frequent with iNPWT (RR, 4.51; 95% CI, 2.37-8.58); device-related adverse events were also increased (RR, 11.87; 95% CI, 4.74-29.74).
- No significant differences were observed for organ-space SSI, readmission, or mortality.
Why it matters
The pooled trial evidence suggests iNPWT can reduce incisional infections and several wound complications, but these benefits must be weighed against increased skin blistering and device-related harms. The findings clarify that the intervention’s effects are not uniform across outcomes and provide a basis for considering patient risk and potential harms when evaluating its use.
What to keep in mind
The abstract does not report limitations specific to the review. The pooled estimates combine trials across adult surgical populations, and the abstract does not describe variation in effects by procedure or baseline risk.