Postoperative negative pressure wound therapy is associated with decreased surgical site infections in all lower extremity amputations

Gantz, Owen; Rynecki, Nicole D.; Para, Ashok; Levidy, Michael F; Beebe, Kathleen S.

doi:10.1016/j.jor.2020.09.005

Cited by 6 publications

(9 citation statements)

References 33 publications

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“…A total of 1021 distinctive studies were found, of which 12 studies (between 2010 and 2021) satisfied the inclusion criteria and were comprised in the study. 2,[9][10][11][12][13][14][15][16][17][18][19] The 12 studies included 3555 subjects with closed incisions in orthopaedic trauma surgery at the start of the study: 1833 of them were provided with negative pressure wound therapy and 1722 were conventional wound dressings. All studies evaluated the effect of negative pressure wound therapy compared with conventional wound dressings on closed incisions in orthopaedic trauma surgery.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 1021 distinctive studies were found, of which 12 studies (between 2010 and 2021) satisfied the inclusion criteria and were comprised in the study 2,9‐19 …”

Section: Resultsmentioning

confidence: 99%

“…This meta‐analysis study based on 12 studies included 3555 subjects with closed incisions in orthopaedic trauma surgery at the start of the study: 1833 of them were provided with negative pressure wound therapy and 1722 were conventional wound dressings 2,9‐19 . Negative pressure wound therapy had significantly lower deep surgical site infection, superficial surgical site infection, and wound dehiscence compared with conventional wound dressings in subjects with closed incisions in orthopaedic trauma surgery.…”

Section: Discussionmentioning

confidence: 99%

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Negative pressure wound therapy compared with conventional wound dressings for closed incisions in orthopaedic trauma surgery: A meta‐analysis

Xie

Dai

et al. 2021

International Wound Journal

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We performed a meta-analysis to evaluate the effect of negative pressure wound therapy compared with conventional wound dressings on closed incisions in orthopaedic trauma surgery. A systematic literature search up to October 2021 was done and 12 studies included 3555 subjects with closed incisions in orthopaedic trauma surgery at the start of the study: 1833 of them were provided with negative pressure wound therapy and 1722 were conventional wound dressings. They were reporting relationships about the effect of negative pressure wound therapy compared with conventional wound dressings on closed incisions in orthopaedic trauma surgery. We calculated the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) to assess the effect of negative pressure wound therapy compared with conventional wound dressings on closed incisions in orthopaedic trauma surgery using the dichotomous and continuous methods with a random or fixed-effect model. Negative pressure wound therapy had significantly lower deep surgical site infection (OR, 0.65; 95% CI, 0.48-0.88, P = .005), superficial surgical site infection (OR, 0.23; 95% CI, 0.11-0.49, P = .31), and wound dehiscence (OR, 0.41; 95% CI, 0.21-0.80, P = .009) compared with conventional wound dressings in subjects with closed incisions in orthopaedic trauma surgery. However, negative pressure wound therapy had no significant effect on the length of hospital stay (MD, 0.29; 95% CI, À2.00-2.58, P = .80) compared with conventional wound dressings in subjects with closed incisions in orthopaedic trauma surgery. Negative pressure wound therapy had significantly lower deep surgical site infection, superficial surgical site infection, and wound dehiscence; however, negative pressure wound therapy had no beneficial effect on the length of hospital stay compared with conventional wound dressings in subjects with closed incisions in orthopaedic trauma surgery.Further studies are required to validate these findings.Weiwei Xie and Lingyan Dai contributed equally to this study.

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Section: Resultsmentioning

confidence: 99%

“…A total of 1021 distinctive studies were found, of which 12 studies (between 2010 and 2021) satisfied the inclusion criteria and were comprised in the study 2,9‐19 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Negative pressure wound therapy compared with conventional wound dressings for closed incisions in orthopaedic trauma surgery: A meta‐analysis

Xie

Dai

et al. 2021

International Wound Journal

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“…In standard gauze wound dressings, dressings have to be changed in a repetitive interval. Depending on the postinterventional bleeding from the wound, repetitive changes are necessary within the first 5 days after surgery (11,15,16). Thus, not only does the microenvironment of the wound gets disrupted but a change of dressing is done at the bedside under semi-sterile circumstances, which leads to a higher risk of surgical-site infection (1,17).…”

Section: Discussionmentioning

confidence: 99%

“…These papers were scanned, and any duplicates or topic-unrelated articles were excluded. After analyzing the eligibility criteria, three of the seven studies could be included in our quantitative analysis (2,11,12). There were three retrospective casecontrol studies containing a total of 457 patients.…”

Section: Study Selectionmentioning

confidence: 99%

Incisional negative pressure wound therapy to reduce surgical-site infections in major limb amputations: a meta-analysis

et al. 2022

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Purpose Incisional negative pressure wound therapy (iNPWT) has shown effectiveness in the treatment of high-risk surgical wounds. Especially patients with diabetes-induced peripheral arterial disease undergoing major limb amputation have a high intrinsic risk for post-surgical wound infections. While normal gauze wound dressings do not cause stimulation of microvasculature, iNPWT might improve wound healing and reduce wound complications. The purpose of this study was to systematically review the literature for rates of wound complications and readmissions, as well as post-surgical 30-day mortality. Methods We conducted a systematic review searching the Cochrane, PubMed, and Ovid databases. Inclusion criteria were the modified Coleman methodology Score >60, non-traumatic major limb amputation, and adult patients. Traumatic amputations and animal studies were excluded. Relevant articles were reviewed independently by referring to the title and abstract. In a meta-analysis, we compared 3 studies and 457 patients. Results A significantly overall lower rate of postoperative complications is associated with usage of iNPWT (odds ratio (OR) = 0.52; 95% CI: 0.30–0.89; P = 0.02). There was no significant improvement for 30-day mortality, when iNPWT was used (OR= 081; 95% CI: 0.46 – 1.45; P = 0.48). Nevertheless, we did not note a significant difference in the readmission rate or revision surgery between the two groups. Conclusion Overall, the usage of iNPWT may reduce the risk of postoperative wound complications in major lower limb amputations but does not improve 30-day mortality rates significantly. However, to anticipate surgical-site infection, iNPWT has shown effectiveness and thus should be used whenever applicable.

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A systemic review and a meta‐analysis on the influences of closed incisions in orthopaedic trauma surgery by negative pressure wound treatment compared with conventional dressings

Zhang

2022

International Wound Journal

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We performed a meta‐analysis to evaluate the influences of closed incisions in orthopaedic trauma surgery (OTS) by negative pressure wound treatment (NPWT) compared with conventional dressings. A systematic literature search up to March 2022 was done and 14 studies included 3935 subjects with OTS at the start of the study; 2023 of them used NPWT and 1912 were conventional dressings. They were reporting relationships between the influences of closed incisions in OTS by NPWT compared with conventional dressings. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to assess the influences of closed incisions in OTS by NPWT compared with conventional dressings using the dichotomous methods with a random or fixed‐effect model. NPWT had significantly lower deep surgical site infections (SSIs) (OR, 0.65; 95% CI, 0.48‐0.87, P = .004), superficial SSIs (OR, 0.34; 95% CI, 0.19‐0.61, P < .001), and wound dehiscence (OR, 0.41; 95% CI, 0.21‐0.80, P = .009) compared with conventional dressings in subjects with closed incisions in OTS. NPWT showed a beneficial effect on deep SSIs, superficial SSIs, and wound dehiscence compared with conventional dressings in subjects with closed incisions in OTS. Further studies are required to validate these findings.

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Postoperative negative pressure wound therapy is associated with decreased surgical site infections in all lower extremity amputations

Cited by 6 publications

References 33 publications

Negative pressure wound therapy compared with conventional wound dressings for closed incisions in orthopaedic trauma surgery: A meta‐analysis

Negative pressure wound therapy compared with conventional wound dressings for closed incisions in orthopaedic trauma surgery: A meta‐analysis

Incisional negative pressure wound therapy to reduce surgical-site infections in major limb amputations: a meta-analysis

A systemic review and a meta‐analysis on the influences of closed incisions in orthopaedic trauma surgery by negative pressure wound treatment compared with conventional dressings

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