(CR-011) Closed Incision Negative Pressure Therapy Versus Standard of Care Over Closed Abdominal Surgical Incisions in the Reduction of Surgical Site Complications: A Systematic Review and Meta-Analysis of Comparative Studies

Christopher Mantyh, MD; Ronald Silverman, MD; Christine Bongards, PhD; Leah Griffin, MS – 3M

Introduction: Surgical site complications (SSCs) can be serious and even life-threatening for patients. Although several studies have linked closed incision negative pressure therapy (ciNPT)* to decreases in wound complications across surgical disciplines, the benefit in abdominal incisions remains unclear. This systematic review and meta-analysis evaluated the effect of ciNPT on post-surgical and health utilization outcomes for patients undergoing open abdominal surgical procedures.

Methods: A systematic literature search using PubMed, EMBASE, and QUOSA was performed for publications written in English, comparing ciNPT to standard of care dressings for patients undergoing abdominal surgical procedures between January 2005 and August 2021. Characteristics of study participants, surgical procedure, dressing used, duration of treatment, post-surgical outcomes, and follow up data were extracted. Meta-analyses were performed using random-effects models. Dichotomous outcomes were summarized using risk ratios and mean differences were used to assess continuous variables. A cost analysis was conducted using inputs from the meta-analysis and cost estimates from a national database.

Results: The literature search identified 22 studies for inclusion in the analysis. Significant reductions in relative risk of SSC, surgical site infection (SSI), superficial SSI, and dehiscence were associated with ciNPT use (p < 0.05). ciNPT use was also associated with a reduced risk of readmission and a 2.6-day reduction in hospital length of stay (LOS) (p < 0.05). The estimated cost savings attributed to ciNPT use was $5,146 per patient.

Discussion: These findings indicate that ciNPT use for patients undergoing open abdominal procedures can help reduce SSCs and associated hospital LOS, readmissions, and costs of care.