Polomska Katarzyna, Kowalik Janina, Kobiela Jarek, Spychalski Piotr
Department of Oncological, Transplant and General Surgery, Medical University of Gdansk, Poland.
Int Wound J. 2025 Apr;22(4):e70199. doi: 10.1111/iwj.70199.
Open incision negative pressure wound therapy (NPWT) combines delayed closure with negative pressure to prevent surgical site infection (SSI). Its effectiveness in preventing SSI remains unclear, complicating its risk-benefit assessment. PubMed and Web of Science databases were searched for relevant English studies. Two reviewers independently screened titles and abstracts using the ASReviewer tool. Full-text articles were assessed for eligibility. Eight studies were included in the systematic review and five were pooled in the meta-analysis. Data extraction followed the PRISMA guidelines, and the risk of bias was assessed. A meta-analysis was performed using a random-effects model for SSI occurrence. Eight studies (three RCTs and five cohort studies) with 1655 patients were included. Studies were pooled based on control interventions: primary closure (PC) or delayed primary closure (DPC). Pooled odds ratio (OR) estimates favoured NPWT over PC for SSI reduction (OR, 0.15; 95% CI, 0.02-0.87). No significant SSI risk difference was found between the NPWT and DPC groups (OR, 0.28; 95% CI, 0.06-1.27). Preventive NPWT is associated with a reduced risk of SSI in abdominal surgery compared to PC. Our findings indicate that standardising treatment and reporting protocols could improve future evaluations of NPWT effectiveness. Trial Registration: PROSPERO identifier: CRD42024401669.
开放性切口负压伤口治疗（NPWT）将延迟闭合与负压相结合以预防手术部位感染（SSI）。其预防SSI的有效性尚不清楚，这使其风险效益评估变得复杂。检索了PubMed和Web of Science数据库中的相关英文研究。两名评审员使用ASReviewer工具独立筛选标题和摘要。对全文进行资格评估。八项研究纳入系统评价，五项研究纳入荟萃分析。数据提取遵循PRISMA指南，并评估偏倚风险。使用随机效应模型对SSI发生情况进行荟萃分析。纳入了八项研究（三项随机对照试验和五项队列研究），共1655例患者。根据对照干预措施进行分组：一期缝合（PC）或延迟一期缝合（DPC）。汇总比值比（OR）估计显示，在减少SSI方面，NPWT优于PC（OR，0.15；95%CI，0.02-0.87）。NPWT组和DPC组之间未发现显著的SSI风险差异（OR，0.28；95%CI，0.06-1.27）。与PC相比，预防性NPWT与腹部手术中SSI风险降低相关。我们的研究结果表明，标准化治疗和报告方案可以改善未来对NPWT有效性的评估。试验注册：PROSPERO标识符：CRD42024401669。
