Closed-incision negative-pressure wound therapy in abdominal wall reconstruction: a systematic review and meta-analysis.

IF 2.7 2区医学 Q1 SURGERY

Hernia Pub Date : 2026-08-01 DOI:10.1007/s10029-026-03744-1

Jorge Henrique Cavalcanti Orestes Cardoso, Bernardo Gabriele Collaco, Jessica Zilberman Macret, Denise Padilha Abs de Almeida, Mariana de Macedo Torves, Raquel Nogueira, Flavio Malcher, Diego Laurentino Lima

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引用次数: 0

Abstract

Background: Closed-incision negative-pressure wound therapy (ciNPWT) has been shown to reduce complications in high-risk wounds, but there is still no consensus in literature to whether it is effective when compared to standard wound dressing (SWD). Therefore, we aimed to perform a systematic review and meta-analysis to assess the ongoing uncertainty regarding its clinical benefits.

Methods: PubMed, Embase and Web of Sciences were systematically searched from inception to November 2025 for both observational and randomized studies comparing ciNPWT with SWD for patients submitted to abdominal wall reconstruction (AWR). A DerSimonian-Laird random-effect model and heterogeneity (assessed with Cochran's Q test and I² statistics) were performed using R software (version 4.4.0).

Results: 16 studies comprising 1,859 patients which underwent AWR, of whom 50% received ciNPWT and 50% SWD. The mean age was 56 years. The analysis showed that ciNTWT group presented significant reductions in both SSO (OR 0.56; 95%CI 0.36 to 0.86; p-value = 0.008; I² = 69.5%) and SSI (OR 0.61; 95%CI 0.39 to 0.91; p-value = 0.032; I² = 51.6%), no difference regarding readmission (OR 0.61; 95%CI 0.35 to 1.05; p-value = 0.072; I² = 26.5% ), reoperation (OR 0.69; 95%CI 0.39 to 1.23; p-value = 0.205; I² = 22.3%), hernia recurrence rates (OR 0.61; 95%CI 0.29 to 1.29; p-value = 0.1984; I² = 24.3%) and length of hospital stay (MD 0.26; 95%CI -1.22 to 1,75; p-value 0.729; I² = 92.1%).

Conclusion: ciNPWT was associated with lower odds of SSI and SSO with no difference in LOS when compared to SWD.

查看原文本刊更多论文

封闭切口负压伤口治疗腹壁重建术：系统回顾和荟萃分析。

背景：闭合切口负压伤口治疗（ciNPWT）已被证明可以减少高风险伤口的并发症，但与标准伤口敷料（SWD）相比，其是否有效，文献中仍未达成共识。因此，我们旨在进行系统回顾和荟萃分析，以评估其临床益处的不确定性。方法：系统检索PubMed、Embase和Web of Sciences从成立到2025年11月的观察性和随机研究，比较ciNPWT与SWD对腹壁重建（AWR）患者的疗效。使用R软件（版本4.4.0）进行dersimonan - laird随机效应模型和异质性（采用Cochran’s Q检验和I²统计量进行评估）。结果：16项研究包括1859例AWR患者，其中50%接受ciNPWT， 50%接受SWD。平均年龄为56岁。分析显示，ciNTWT组的SSO （OR 0.56; 95%CI 0.36 ~ 0.86； p值= 0.008;I²= 69.5%）和SSI （OR 0.61; 95%CI 0.39 ~ 0.91； p值= 0.032;I²= 51.6%）均显著降低，再入院（OR 0.61; 95%CI 0.35 ~ 1.05； p值= 0.072;I²= 26.5%）、再手术（OR 0.69; 95%CI 0.39 ~ 1.23； p值= 0.205;I²= 22.3%）、疝复发率(OR 0.61; 95%CI 0.29 ~ 1.29； p值= 0.1984；I²= 24.3%)和住院时间（MD 0.26; 95%CI -1.22 ~ 1.75； p值0.729;I²= 92.1%）。结论：与SWD相比，ciNPWT与SSI和SSO的发生率较低相关，而LOS的发生率无差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.