Incisional negative pressure wound therapy for clean-contaminated wounds in abdominal surgery: a systematic review and meta-analysis of randomized controlled trials,Expert Review of Gastroenterology & Hepatology

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Incisional negative pressure wound therapy for clean-contaminated wounds in abdominal surgery: a systematic review and meta-analysis of randomized controlled trials
Expert Review of Gastroenterology & Hepatology ( IF 3.8 ) Pub Date : 2021-08-18 , DOI: 10.1080/17474124.2021.1967143
Shiyi Gong _{1,

2,

3,

4} , Jia Yang _{1,

2,

3,

4} , Tingting Lu _{1,

2,

3,

4} , Hongwei Tian ₁ , Yunxia Huang _{1,

2,

3} , Shaoming Song _{1,

3,

4} , Caining Lei _{1,

3,

4} , Wenwen Yang _{1,

3,

4} , Kehu Yang _{3,

4,

5} , Tiankang Guo _{1,

2,

3}

Affiliation

ABSTRACT

Objective

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.

Methods

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.

Results

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, P = 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.

Conclusions

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.

中文翻译：

腹部手术清洁污染伤口的切口负压治疗：随机对照试验的系统评价和荟萃分析

摘要

客观的

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) 中的作用仍然存在争议。这项荟萃分析旨在评估使用 iNPWT 是否可以减少清洁污染腹部手术中的 SSI 和其他并发症。

方法

作者搜索了从数据库开始到 2021 年 1 月 23 日的 PubMed、EMBASE、Cochrane 图书馆和 Web of Science，以获取随机对照试验 (RCT)。他们使用 Cochrane Collaboration 偏倚风险工具评估偏倚风险，并使用 RevMan 5.4 进行荟萃分析。

结果

分析了 11 项随机对照试验，包括 4112 名患者，其中 2057 名接受 iNPWT 治疗，2055 名接受标准敷料治疗。接受 iNPWT 干预的患者的 SSI 率（OR = 0.76, 95% CI = 0.61–0.94, P = 0.01）显着低于接受标准敷料的患者。组间切口裂开、血清肿和再入院率无统计学差异。