Negative pressure wound therapy in infants with complex abdominal wounds: A systematic review of clinical applications and closure strategies.

BACKGROUND

Literature supporting negative pressure wound therapy use for complex abdominal wounds in infants consists mostly of case studies and small retrospective series. Its applications, treatment protocols, and reported outcomes in infants remain poorly characterized. This systematic review describes the use of negative pressure wound therapy in infants with complex abdominal wounds, with emphasis on treatment protocols and closure strategies.

METHODS

This systematic review identified studies reporting negative pressure wound therapy use on abdominal wounds in children younger than 12 months according to PRISMA guidelines. Extracted data included patient characteristics, indications for use, negative pressure wound therapy protocols, therapy duration, definitive closure method, and patient outcomes.

RESULTS

Of 202 publications, 38 met all inclusion criteria, representing 226 infants, of whom 161 received abdominal negative pressure wound therapy. Among 112 infants with open abdominal wounds, the definitive closure strategy was reported for 110. Fifty-two (47%) achieved closure by secondary intention and 58 (53%) underwent delayed primary (tertiary) closure. Among 108 infants with explicitly reported reconstructive outcomes, graft- or flap-based reconstruction was reported in four (3.7%). Treatment protocols and outcome reporting varied across studies.

CONCLUSIONS

Published reports describe NPWT as an adjunct in the management of complex abdominal wounds in infants across a range of indications and closure strategies. However, the evidence consists predominantly of case reports and small retrospective series with heterogeneous protocols, incomplete outcome reporting, and substantial risk of selection and publication bias. These data provide a descriptive summary of reported clinical practice but do not establish whether NPWT improves closure outcomes or reduces the need for reconstructive procedures.