"Negative Pressure Wound Therapy (NPWT) Yields Lower Wound Complication and Surgical Site Infection Rates Compared to Standard Surgical Dressings (SSDs) after Resection of a Malignancy: A Systematic Review and Meta-Analysis".
Plast Reconstr Surg 2022;
150:655e-670e. [PMID:
35791292 DOI:
10.1097/prs.0000000000009448]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND
Negative Pressure Wound Therapy (NPWT) offers many advantages over Standard Surgical Dressings (SSDs) in the treatment of open wounds including accelerated wound healing (72.3% vs 30.8%), cost savings (up to $1,607), and reduced complication rates (35% vs 53%).2-4 Contraindicated by device manufacturers in malignancy-resected wounds for hypothesized risk of tumor recurrence, NPWT is still applied post-operatively due to limited clinical support. A systematic review with meta-analysis was performed to compare NPWT outcomes with SSDs on open wounds with our null hypotheses stating there would be no outcome differences.
METHODS
A systematic review of the literature on NPWT and SSDs on malignancy-resected wounds was conducted following PRISMA guidelines using PubMed, EMBASE, CINAHL, and Cochrane Central databases. Meta-analysis compared group outcomes, including malignancy recurrence, wound complication, and surgical site infection (SSI) rates, with random effects model.
RESULTS
1,634 studies were identified and 27 met eligibility criteria, including 4 randomized control trials (RCTs), 4 prospective cohort studies, and 19 retrospective reviews. Eighty-one percent of papers (n = 22) recommended NPWT use in malignancy-resected wounds. Meta-analysis determined NPWT yielded significantly lower overall SSI (P = 0.004) and wound complication rates (P = 0.01) than SSDs; however, there were no statistically significant differences found for other outcomes between the two groups.
CONCLUSIONS
This review demonstrates favorable outcomes of NPWT over SSDs for malignancy-resected wounds without an increased risk of malignancy recurrence. However, with limited RCTs (detailing only incisional wounds for limited malignancies and anatomic regions), additional high-power RCTs are recommended.
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