Wound complications commonly cause postoperative morbidity and incur high healthcare costs. Evidence shows that negative pressure wound dressings lessen wound complication rates, particularly surgical site infections, after elective laparotomies. However, the clinical utility of prophylactic negative pressure wound dressings for closed emergency laparotomy incisions remains unclear. The present meta-analysis investigated the rates of wound complications after emergency laparotomy following the application of a negative pressure wound dressing.

It performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. It searched PubMed, Embase, Cochrane Registry, Web of Science, and Clinialtrials.gov databases and included all studies comparing negative pressure wound dressings to standard dressings on closed emergency laparotomy incisions.

The study found-

• 1,199 (negative pressure wound dressings: 566, standard dressing: 633) patients from 7 studies.
• The surgical site infection (superficial/deep) rate of 13.6% vs. 25.1% in the negative pressure wound dressing versus standard dressing groups, respectively.
• Significantly lower wound breakdown (skin/fascial dehiscence) in the negative pressure wound dressing (7.7%) group compared to the standard dressing (16.9%) group.
• Significantly lower incidence of overall wound complications in the negative pressure wound dressing (15.9%) group compared to the standard dressing (30.4%) group.
• No significant differences in hospital length-of-stay and readmission rates.

This study proves an association between the Prophylactic negative pressure wound dressings for closed emergency laparotomy incisions and a significant reduction in surgical site infections, wound breakdown, and overall wound complications, thus supporting its clinical use.

Lakhani A, Jamel W, Riddiough GE, et al. Prophylactic negative pressure wound dressings reduces wound complications following emergency laparotomies: A systematic review and meta-analysis. Surgery. 2022;172(3): 949-954. https://doi.org/10.1016/j.surg.2022.05.020.