Meta-analysis Comparing Outcomes of Two Different Negative Pressure Therapy Systems in Closed Incision Management

Singh, Devinder P.; Gabriel, Allen; Silverman, Ronald P.; Griffin, Leah; McGowan, Lucy D’Agostino; D’Agostino, Ralph B.

doi:10.1097/gox.0000000000002259

Cited by 18 publications

(32 citation statements)

References 34 publications

(32 reference statements)

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“…Of note, in the meta-analysis by Singh et al, two different ciNPWT systems were compared, namely one using a foamed dressing and one using a multilayer absorbent dressing. Whilst the ciNPWT device with foamed dressing significantly reduced the rate of SSI, the other absorbent one was not associated with a significant reduction in SSI rate [33].…”

Section: General Surgerymentioning

confidence: 78%

Closed-incision negative-pressure wound management in surgery—literature review and recommendations

et al. 2020

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Summary Background Wound healing deficits and subsequent surgical site infections are potential complications after surgical procedures, resulting in increased morbidity and treatment costs. Closed-incision negative-pressure wound therapy (ciNPWT) systems seem to reduce postoperative wound complications by sealing the wound and reducing tensile forces. Materials and methods We conducted a collaborative English literature review in the PubMed database including publications from 2009 to 2020 on ciNPWT use in five surgical subspecialities (orthopaedics and trauma, general surgery, plastic surgery, cardiac surgery and vascular surgery). With literature reviews, case reports and expert opinions excluded, the remaining 59 studies were critically summarized and evaluated with regard to their level of evidence. Results Of nine studies analysed in orthopaedics and trauma, positive results of ciNPWT were reported in 55.6%. In 11 of 13 (84.6%), 13 of 15 (86.7%) and 10 of 10 (100%) of studies analysed in plastic, vascular and general surgery, respectively, a positive effect of ciNPWT was observed. On the contrary, only 4 of 12 studies from cardiac surgery discovered positive effects of ciNPWT (33.3%). Conclusion ciNPWT is a promising treatment modality to improve postoperative wound healing, notably when facing increased tensile forces. To optimise ciNPWT benefits, indications for its use should be based on patient- and procedure-related risk factors.

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Section: General Surgerymentioning

confidence: 78%

Closed-incision negative-pressure wound management in surgery—literature review and recommendations

et al. 2020

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“…32,33 The highest percentage of published clinical RCTs comparing the use of ciNPT and control groups involves vascular surgery incisions. 13 Enrolled patients have often had comorbidities including obesity, diabetes mellitus, peripheral vascular disease, or chronic obstructive pulmonary disease. 19 Most of the published prospective and retrospective studies have reported that patients treated with ciNPT have showed reduced SSI rates, with the disclaimer that a greater number of large RCTs are necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Use of ciNPT after vascular surgery has been shown in prospective randomized trials to reduce surgical site infection in patients at elevated risk of postsurgical complications. [7][8][9]11,13 Although the use of ciNPT is growing overall, SSI events continue to occur too frequently in high-risk populations. Increased utilization of ciNPT among high-risk vascular patients may potentially reduce SSI rates, but it is important to use this tool appropriately.…”

Section: Introductionmentioning

confidence: 99%

Deep Learning-Based Risk Model for Best Management of Closed Groin Incisions After Vascular Surgery

Chang

Sun

Peiris

et al. 2020

Journal of Surgical Research

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“…Closed incisional negative pressure therapy (ciNPT) has become more popular in recent years and used selectively in those cases where the risk of postoperative incisional complications is high. Singh et al did a meta-analysis showing the clinical benefit of Prevena™, specifically comparing it to other devices on the market [9]. In 2019, Prevena™ received FDA approval to be used to reduce the risk of postoperative infections and dehiscence.…”

Section: Discussionmentioning

confidence: 99%

“…The reduction of lateral tension, edema control, and reduction of bacterial burden all likely played a role in the successful management of this patient. Clinical benefits have been reported to include reduction in infection, hematoma, and seroma [6][7][8][9][10][11]. Additionally, skin perfusion has been shown to improve with negative pressure incisional management in cardiac surgery [12].…”

Section: Discussionmentioning

confidence: 99%

Reducing the Risk of Postoperative Problems With Panniculectomies Using the Prevena Plus™ 125 Incisional Management Dressing

Desvigne¹

2020

Cureus

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Abdominal wall reconstruction procedures have become increasingly popular in recent years as technology and surgical techniques have improved. The downside to these procedures has been the high rate of postoperative complications. Surgical site infections have been reported as high as 33.7% of the $9.8 billion spent annually on these complications. I present the case of a 62-year-old morbidly obese woman who underwent a combined procedure of abdominal wall reconstruction and panniculectomy. A total of 45 lbs of pannus was removed through a transverse incision that extended from hip to hip, measuring 90 cm in length. Following panniculectomy, abdominal wall reconstruction was performed by mobilizing the abdominal skin flap from the lower abdominal panniculectomy incision (avoiding a Tshaped incision with a traditionally high risk of dehiscence), and placement of biologic mesh as an underlay followed by fascial closure. Prevena Plus™ 125 (3M + KCI, San Antonio, TX) was applied for postoperative closed incisional negative pressure therapy (ciNPT) and continued for 10 days. No postoperative complications occurred. The incision healed without incident with no hernia recurrence at one year. ciNPT in high-risk patients can help minimize the risk of postoperative wound healing complications and should be considered in high-risk patients. Those patients undergoing combined procedures and especially morbidly obese patients undergoing combined abdominal wall reconstruction and panniculectomy are at particularly high risk for wound healing complications. ciNPT should be considered as a postoperative dressing of choice in this challenging patient population.

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Meta-analysis Comparing Outcomes of Two Different Negative Pressure Therapy Systems in Closed Incision Management

Abstract: Supplemental Digital Content is available in the text.

Cited by 18 publications

References 34 publications

Closed-incision negative-pressure wound management in surgery—literature review and recommendations

Closed-incision negative-pressure wound management in surgery—literature review and recommendations

Deep Learning-Based Risk Model for Best Management of Closed Groin Incisions After Vascular Surgery

Reducing the Risk of Postoperative Problems With Panniculectomies Using the Prevena Plus™ 125 Incisional Management Dressing

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