Closed Incision Negative Pressure Therapy: Review of the Literature

Luis G Fernandez; Marc R Matthews; Pablo Sibaja Alvarez; Scott Norwood; David H Villarreal

doi:10.7759/cureus.5183

Closed Incision Negative Pressure Therapy: Review of the Literature

Cureus. 2019 Jul 21;11(7):e5183. doi: 10.7759/cureus.5183.

Authors

Luis G Fernandez¹, Marc R Matthews², Pablo Sibaja Alvarez³, Scott Norwood⁴, David H Villarreal⁵

Affiliations

¹ Surgery, Trauma Wound Care, University of Texas Health Science Center, Tyler, USA.
² Surgery, Arizona Burn Center, Phoenix, USA.
³ General Surgery, Universidad Federada San Judas Tadeo, San Jose, CRI.
⁴ Surgery, University of Texas Health Science Center, Tyler, USA.
⁵ Trauma, Acute Care Surgery, Surgical Critical Care, University of Texas Health Science Center, Tyler, USA.

Abstract

Surgical site infection and other common surgical site complications (dehiscence, hematoma, and seroma formation) can lead to serious and often life-threatening complications. Gauze, adhesive dressings, and skin adhesives have traditionally been utilized for incision management. However, the application of negative pressure wound therapy over clean, closed surgical incisions (closed incision negative pressure therapy, ciNPT), has become a recent option for incision management. A brief review of ciNPT clinical evidence and health economic evidence are presented. A brief literature review was performed using available publication databases (PubMed, Ovid®, Embase®, and QUOSA™) for articles in English reporting on the use of ciNPT between October 1, 2016, to March 31, 2019. The successful application of ciNPT over clean, closed wounds has been reported in a broad spectrum of patients and operative interventions, resulting in favorable clinical results. Four of the five studies that examined health economics following the use of ciNPT reported a potential reduction in the cost of care. The authors' own experience and published results suggest that patients at high risk for developing a surgical site complication may benefit from the use of ciNPT during the immediate postoperative period. Additional studies are needed across various surgical disciplines to further assess the safety, and cost-effectiveness of ciNPT use in patient populations.

Keywords: closed incision negative pressure therapy; health economics; literature reviews.

Publication types

Review

Grants and funding

LG Fernández and P Sibaja Alvarez are consultants for KCI, an ACELITY Company. MR Matthews is a surgical consultant and is on the Speakers Bureau of Steadmed/Urgo and KCI, an ACELITY Company.