Negative pressure wound therapy for surgical site infections: A systematic review and meta-analysis

Abstract

Objective: Negative pressure wound therapy is one of the most common treatments for infected wounds. The aim of this meta-analysis was to compare the efficacy of negative pressure wound therapy with conventional treatment methods in the treatment of surgical site infection.

Design: This study is registered with International Prospective Register of Systematic Reviews.

Data sources: The Pubmed, Embase and the Cochrane Central Register of Controlled Trials databases were searched.

Methods: The systematic review was searched by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. All trials reporting the use of negative pressure wound therapy for surgical site infection treatment were included regardless of surgery type. The primary outcome measure was wound healing. Secondary outcomes were length of hospital stay, medical costs, adverse events, and reoperation rates. Results are presented with 95% confidence intervals and report estimates as odds ratios. Heterogeneity was determined through the I² test, with I² > 50% indicating substantial heterogeneity and p < .10 significance. The search was performed on 10 March 2020.

Results: We identified 13 eligible trial comparisons, of which 2 were randomized controlled trials and 11 cohort study. Negative pressure wound therapy in surgical site infection (SSI) patients significantly increased wound healing rate, accelerated wound healing time, increased daily wound healing area, reduced hospital stay, and reduced adverse events. However, negative pressure wound therapy was associated with increased medical costs.

Conclusion: Negative pressure wound therapy may be more effective for the treatment of surgical site infection relative to conventional debridement, dressings and other treatments. However, further high-quality randomized controlled trials are needed to determine the most optimal application of negative pressure wound therapy.

Impact: Negative pressure wound therapy is the best treatment strategy for surgical site infection. This study can improve medical practitioners' awareness of negative pressure wound therapy for surgical site infection, promoting the development of relevant randomized controlled trials.

Keywords: advanced antimicrobial dressings; adverse event; closed suction irrigation system; continues irrigation suction systems; negative pressure wound therapy; nursing; surgical site infection; treatment; vacuum-assisted closure; wound healing.