Meta-analyses of Prospective Studies Evaluating Closed Incision Negative Pressure Therapy

Abstract Body: Recently published meta-analyses have shown that patients treated postoperatively with closed incision negative pressure therapy (ciNPT*) had significantly fewer surgical site infections (SSIs) when compared to conventional dressings.1-3 In addition, a significantly lower risk of revision surgery and shorter hospital stay for vascular surgery patients treated postoperatively with ciNPT was reported in one study.1 We performed meta-analyses of up to 27 prospective studies reporting surgical site complications (SSCs) and subsequent interventions (eg, readmission or revision surgery) for a variety of surgery types. Weighted odds ratios (OR) and 95% confidence intervals were calculated to pool publication results for analysis. Treatment effects were combined using Mantel-Haenszel OR, and a chi-square test was used to assess heterogeneity. Like previous meta-analyses, our analysis of 24 of the 27 studies that reported on SSI rates (N=24) showed a highly significant difference in favor of ciNPT over conventional dressings (P< 0.00001). Analysis of nine studies showed a highly significant difference in SSC rates in favor of ciNPT over conventional dressings (P=0.0005), with significant differences in favor of ciNPT related to hematomas (P=0.001; N=7) and seromas (P=0.01; N=7). Although there was a trend toward a difference in surgical site dehiscence in favor of ciNPT, this difference was not statistically significant (P=0.06; N=11). Importantly, there was a statistically significant difference in favor of ciNPT (P=0.004) when assessing the need for revision surgery, which was reported in 11 studies. In addition, ciNPT was significantly favored when assessing the hospital length of stay (P=0.05); however, these data were only reported in five studies. There was not a significant difference when assessing the use of postoperative antibiotics (P=0.19) or hospital readmission (P=0.11). Overall, these data suggest that ciNPT may favorably impact certain SSCs (SSIs and seromas) as well as potentially affect the need for subsequent intervention and reoperation.