Prophylactic negative pressure wound dressings reduces wound complications following emergency laparotomies: A systematic review and meta-analysis

Lakhani, A; Jamel, W; Riddiough, GE; Cabalag, CS; Stevens, S; Liu, DS

Author(s): Lakhani, A; Jamel, W; Riddiough, GE; Cabalag, CS; Stevens, S; Liu, DS;
Details: Publication Year 2022-09,Volume 172,Issue #3,Page 949-954
Journal Title: Surgery
Publication Type: Review
Abstract: BACKGROUND: Wound complications are a common cause of postoperative morbidity and incur significant healthcare costs. Recent studies have shown that negative pressure wound dressings reduce wound complication rates, particularly surgical site infections, after elective laparotomies. The clinical utility of prophylactic negative pressure wound dressings for closed emergency laparotomy incisions remains controversial. This meta-analysis investigated the rates of wound complications after emergency laparotomy when a negative pressure wound dressing was applied. METHODS: A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Cochrane Registry, Web of Science, and Clinialtrials.gov databases were searched from January 1, 2005, to April 1, 2022. All studies comparing negative pressure wound dressings to standard dressings on closed emergency laparotomy incisions were included. RESULTS: A total of 1,199 (negative pressure wound dressings: 566, standard dressing: 633) patients from 7 (prospective: 4, retrospective: 3) studies were identified. Overall, the surgical site infection (superficial/deep) rate was 13.6% (77/566) vs 25.1% (159/633) in the negative pressure wound dressing versus standard dressing groups, respectively (odds ratio 0.43, 95% confidence interval 0.30-0.62). Wound breakdown (skin/fascial dehiscence) was significantly lower in the negative pressure wound dressing (7.7%) group compared to the standard dressing (16.9%) group (odds ratio 0.36, 95% confidence interval 0.19-0.72). The incidence of overall wound complications was significantly lower in the negative pressure wound dressing (15.9%) group compared to the standard dressing (30.4%) group (odds ratio 0.41, 95% confidence interval 0.28-0.59). No significant differences were found in hospital length-of-stay and readmission rates. CONCLUSION: Prophylactic negative pressure wound dressings for closed emergency laparotomy incisions were associated with a significant reduction in surgical site infections, wound breakdown, and overall wound complications, thus supporting its clinical use.
Publisher: Elsevier
Keywords: Bandages; Humans; *Laparotomy/adverse effects; *Negative-Pressure Wound Therapy; Prospective Studies; Retrospective Studies; Surgical Wound Dehiscence/epidemiology/etiology/prevention & control; Surgical Wound Infection/epidemiology/etiology/prevention & control
Department(s): Surgical Oncology
PubMed ID: 35779950
Publisher's Version: https://doi.org/10.1016/j.surg.2022.05.020
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-01-09 06:52:43

Last Modified: 2025-01-09 06:54:51