American journal of surgery · 2026
Evaluating the use of negative pressure wound therapy following stoma reversal - A systematic review and meta-analysis of randomised clinical trials.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Ahmed Ammar I, Davey Matthew G, Donlon Noel E, Carton Eleanor
Аннотация
BACKGROUND: Surgical site infections (SSIs) and delayed wound healing are common complications following stoma reversal. Negative pressure wound therapy (NPWT) has previously demonstrated reduced SSI rates in several other surgical procedures. This systematic review and meta-analysis aimed to evaluate the role of NPWT in reducing SSIs and wound healing time compared to standard dressings following stoma reversal.
METHODS: A systematic review was performed according to PRISMA guidelines. Meta-analysis were performed using RevMan version 5.4 software. Primary outcomes were SSI rates and complete wound healing time (CWHT); secondary outcomes included length of hospital stay (LOS) and hematoma formation. Data was assessed for bias using Cochrane's Risk of Bias tool and synthesised through meta-analysis.
RESULTS: Six randomised clinical trials published between 2016 and 2024 were included. These involved 332 patients, of whom 171 were randomised to NPWT (51.5%) and 161 to standard dressings (control) (48.5%). A non-significant difference was observed for mean patient age and American Society of Anaesthesiologists (ASA) grade (all P > 0.050). NPWT failed to demonstrate significant difference in SSI rates compared to standard care (odds ratio (OR): 1.02, 95% confidence interval (CI): 0.47-2.20, p = 0.96, however, significantly reduced CWHT (MD: -2.72, 95% CI: -4.08 to -1.35, p = 0.0001). Importantly, no differences were observed in the LOS, hematoma rates, or overall wound complications.
CONCLUSION: While NPWT failed to significantly reduce SSIs incidence, there was a significant reduction in CWHT. Accordingly, the judicious use of NPWT may be adopted, with the most value likely for patients deemed to be high-risk.
METHODS: A systematic review was performed according to PRISMA guidelines. Meta-analysis were performed using RevMan version 5.4 software. Primary outcomes were SSI rates and complete wound healing time (CWHT); secondary outcomes included length of hospital stay (LOS) and hematoma formation. Data was assessed for bias using Cochrane's Risk of Bias tool and synthesised through meta-analysis.
RESULTS: Six randomised clinical trials published between 2016 and 2024 were included. These involved 332 patients, of whom 171 were randomised to NPWT (51.5%) and 161 to standard dressings (control) (48.5%). A non-significant difference was observed for mean patient age and American Society of Anaesthesiologists (ASA) grade (all P > 0.050). NPWT failed to demonstrate significant difference in SSI rates compared to standard care (odds ratio (OR): 1.02, 95% confidence interval (CI): 0.47-2.20, p = 0.96, however, significantly reduced CWHT (MD: -2.72, 95% CI: -4.08 to -1.35, p = 0.0001). Importantly, no differences were observed in the LOS, hematoma rates, or overall wound complications.
CONCLUSION: While NPWT failed to significantly reduce SSIs incidence, there was a significant reduction in CWHT. Accordingly, the judicious use of NPWT may be adopted, with the most value likely for patients deemed to be high-risk.