Gansu Provincial Hospital, Lanzhou, Gansu, China.
Ningxia Medical University, Yinchuan, Ningxia, China.
Expert Rev Gastroenterol Hepatol. 2021 Nov;15(11):1309-1318. doi: 10.1080/17474124.2021.1967143. Epub 2021 Aug 18.
The role of incisional negative-pressure wound therapy (iNPWT) in preventing surgical site infections (SSIs) in clean-contaminated abdominal wounds is still controversial. This meta-analysis was performed to evaluate whether the use of iNPWT could reduce SSIs and other complications in clean-contaminated abdominal surgery.
The authors searched PubMed, EMBASE, Cochrane library, and Web of Science from database inception to 23 January 2021 for randomized controlled trials (RCTs). They assessed the risk of bias using the Cochrane Collaboration risk of bias tool and conducted a meta-analysis using RevMan 5.4.
Eleven RCTs, including 4112 patients, were analyzed, of which 2057 were treated with iNPWT and 2055 with standard dressings. The SSI rates (OR = 0.76, 95% CI = 0.61-0.94, = 0.01), in patients undergoing an iNPWT intervention were significantly lower than those in patients receiving standard dressings. There was no statistically significant difference between the rates of incision dehiscence, seroma, and readmission between groups.
Application of iNPWT for clean-contaminated wounds in abdominal surgery reduced SSI rates but showed similar rates of wound dehiscence, seroma, and readmission compared with standard dressings.
切口负压伤口治疗(iNPWT)在预防清洁污染腹部伤口的手术部位感染(SSI)方面的作用仍存在争议。本荟萃分析旨在评估 iNPWT 的使用是否可以降低清洁污染性腹部手术中的 SSI 和其他并发症。
作者从数据库建立到 2021 年 1 月 23 日,在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 上搜索了随机对照试验(RCT)。他们使用 Cochrane 协作风险偏倚工具评估了风险偏倚,并使用 RevMan 5.4 进行了荟萃分析。
分析了 11 项 RCT,共 4112 名患者,其中 2057 名患者接受 iNPWT 治疗,2055 名患者接受标准敷料治疗。接受 iNPWT 干预的患者的 SSI 发生率(OR=0.76,95%CI=0.61-0.94, =0.01)明显低于接受标准敷料的患者。两组之间的切口裂开、血清肿和再入院率无统计学差异。
在腹部手术中,对清洁污染伤口应用 iNPWT 可降低 SSI 发生率,但与标准敷料相比,其切口裂开、血清肿和再入院率相似。