(CR-012) Closed Incision Negative Pressure Therapy Versus Standard of Care Over Closed Plastic Surgery Incisions in the Reduction of Surgical Site Complications: A Systematic Review and Meta-Analysis of Comparative Studies

Allen Gabriel, MD; Devinder Singh, MD; Ronald Silverman, MD; Christine Bongards, PhD; Leah Griffin, MS

Introduction: Surgical site complications (SSCs) are not uncommon in plastic surgery procedures due to characteristics of the incisions and the patients undergoing these procedures. Closed incision negative pressure therapy (ciNPT) has been used to manage surgical incisions across surgical specialties. This systematic review and meta-analysis examined the impact of ciNPT* on risk of SSCs following plastic surgery.

Methods: A systematic review was conducted to identify studies published between January 2005 and July 2021 comparing ciNPT versus traditional standard of care dressings for patients undergoing plastic surgery. Meta-analyses were performed using a random effects model. A cost analysis was conducted using inputs from the meta-analysis and cost estimates from a national hospital database.





Results: Sixteen studies met the inclusion criteria. Eleven studies were included in the evaluation of SSCs where a significant difference was seen in favor of ciNPT (p< 0.001). Significant benefits in favor of ciNPT were also seen for dehiscence (p=0.001), skin necrosis (p=0.002), and scarring (p=0.014). Hospital length of stay was decreased by 0.61 days for patients receiving ciNPT (p< 0.001). There were no differences in the rates of SSIs (p=0.113) and seromas (p=0.143). While not statistically significant, there was a decrease in rate of reoperations (p=0.074), fluid volume removed from the drains (p=0.069) and drain days (-1.97 days, p=0.093) for ciNPT patients. The estimated cost savings attributed to ciNPT use was $904 (USD) per patient.

Discussion: The study findings suggest that ciNPT may reduce incidence of SSCs in plastic surgery procedures and related health care utilization and costs.