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2025 ; 26
(1
): 991
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Closed incision management with negative pressure wound therapy: a systematic
review and meta-analysis of orthopedic trauma outcomes
#MMPMID41131516
Zhang J
; Xu R
; Qian J
; Cai X
BMC Musculoskelet Disord
2025[Oct]; 26
(1
): 991
PMID41131516
show ga
We conducted a systematic review and meta-analysis to evaluate the effectiveness
of negative pressure wound therapy (NPWT) compared to traditional wound care for
closed incisions following orthopedic trauma surgery. Wound complications,
including surgical site infections (SSIs) and wound dehiscence, are common in
orthopedic trauma surgery, affecting a significant portion of patients. To
address this, we analyzed data from 3994 participants across 15 trials, with 2045
patients receiving NPWT and 1949 receiving conventional wound dressings. Our
results show that NPWT was associated with reduced deep surgical site infection
(OR, 0.60; 95% CI, 0.45?0.81, P?=?0.0005), superficial surgical site infection
(OR, 0.34; 95% CI, 0.19?0.61, P?=?0.003), and wound dehiscence (OR, 0.41; 95% CI,
0.21?0.80, P?=?0.009) compared to traditional dressings. Additionally, NPWT was
associated with a reduction in hospital stays (MD, 0.89; 95% CI, 0.49?1.30,
P?=?0.0001). However, the clinical significance of this modest reduction should
be interpreted cautiously given the high heterogeneity (I(2)?=?92%) observed in
this outcome. Despite these positive outcomes, the study's limitations, such as
the lack of long-term follow-up, the potential for publication bias, moderate to
high heterogeneity in some outcomes, and the inclusion of both randomized and
non-randomized studies, suggest that additional high-quality randomized
controlled trials are necessary to fully validate the long-term effectiveness and
safety of NPWT in this context. SUPPLEMENTARY INFORMATION: The online version
contains supplementary material available at 10.1186/s12891-025-08986-1.