The Efficacy of Prophylactic Negative Pressure Wound Therapy for Closed Incisions in Breast Surgery: A Systematic Review and Meta-Analysis

• Published in: World journal of surgery 2020-05, Vol.44 (5), p.1526-1537
• Main Authors: Cagney, David, Simmons, Lydia, O’Leary, Donal Peter, Corrigan, Mark, Kelly, Louise, O’Sullivan, M. J., Liew, Aaron, Redmond, Henry Paul
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Bandages; Breast; Breast - surgery; Cardiac Surgery; Complications; Dehiscence; Dressings; General Surgery; Hematoma; Hematoma - prevention & control; Heterogeneity; Humans; Infectious diseases; Lymphatic drainage; Medicine; Medicine & Public Health; Meta-analysis; Necrosis; Negative-Pressure Wound Therapy; Pressure; Pressure ulcers; Scientific Review; Seroma - prevention & control; Statistical analysis; Surgery; Surgical site infections; Surgical Wound - therapy; Surgical Wound Dehiscence - prevention & control; Surgical Wound Infection - prevention & control; Systematic review; Thoracic Surgery; Vascular Surgery; Wound Healing
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-019-05335-x

Background Negative pressure wound therapy (NPWT) is a promising advance in the management of closed surgical incisions. NPWT application induces several effects locally within the wound including reduced lateral tension and improving lymphatic drainage. As a result, NPWT may improve wound healing and reduce surgical site complications. We aim to evaluate the efficacy of prophylactic application of NPWT in preventing surgical site complications for closed incisions in breast surgery. Methods This systematic review was reported according to PRISMA guidelines. The protocol was published in PROSPERO (CRD42018114625). Medline, Embase, CINAHL and Cochrane Library databases were searched for studies which compare the efficacy of NPWT versus non-NPWT dressings for closed incisions in breast surgery. Specific outcomes of interest were total wound complications, surgical site infection (SSI), seroma, haematoma, wound dehiscence and necrosis. Results Seven studies (1500 breast incisions in 904 patients) met the inclusion criteria. NPWT was associated with a significantly lower rate of total wound complications [odds ratio (OR) 0.36; 95% CI 0.19–069; P  = 0.002], SSI (OR 0.45; 95% CI 0.24–0.86; P  = 0.015), seroma (OR 0.28; 95% CI 0.13–0.59; P  = 0.001), wound dehiscence (OR 0.49; 95% CI 0.32–0.72; P