PROPHYLACTIC NEGATIVE PRESSURE WOUND THERAPY VS. C mahmoudalbashier934@gmail.com

 

PROPHYLACTIC NEGATIVE PRESSURE WOUND THERAPY VS. C

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Egypt

Oral or Poster

Surgical site infections (SSIs) are a common cause of postoperative complications, especially following laparotomy due to the extensive incision and risk of contamination. Prophylactic negative pressure wound therapy (pNPWT) has been proposed as an alternative to conventional dressings, potentially reducing infection risk by improving perfusion, minimizing edema, and preventing bacterial colonization.

A systematic literature search was conducted in PubMed (MEDLINE), EMBASE, Scopus, Web of Science, and Cochrane CENTRAL up to March 3, 2025, Eligible studies were randomized controlled trials (RCTs) comparing pNPWT with conventional dressings in patients undergoing open laparotomy. Data extraction and risk-of-bias assessment were independently performed. Statistical analyses were conducted using R software, with heterogeneity assessed using I² statistics and Chi-square tests. A random-effects model was applied when I² exceeded 50%.

We included 28 randomized controlled trials involving 4,594 patients (2,316 pNPWT; 2,278 conventional dressing). pNPWT was associated with significantly lower SSI risk (RR 0.56, 95% CI 0.44–0.71, P < 0.0001), wound dehiscence (OR 0.41), seroma/lymphatic issues (OR 0.46), and shorter hospital stays (MD -0.74 days). There were no significant differences in operative time, blood loss, hematoma, bleeding, readmission, reoperation, or mortality.

pNPWT appears to be more effective than conventional dressing in reducing SSI risk and related wound complications after laparotomy. However, benefits did not extend to all surgical outcomes. The conclusion should be interpreted cautiously, given limitations including some retrospective data and variation in study quality. Further well-designed trials are necessary to evaluate pNPWT’s effects on healing time, psychological outcomes, and healthcare costs.