Early wound closure with negative-pressure irrigation-drainage accelerates healing and improves early appearance: a comparative study.

OBJECTIVE

Delayed wound healing remains a common clinical challenge and is associated with increased infection risk, prolonged hospitalization, and poor scar outcomes. Whether a multimodal strategy comprising early wound closure supported by continuous negative-pressure irrigation and drainage can improve healing dynamics compared with conventional open management remains insufficiently explored.

METHODS

This comparative clinical study included 62 patients with wounds who were admitted to Yanqing Hospital of Beijing Chinese Medicine Hospital between January and December 2023. Thirty-two patients received conventional open wound care (control group), and 30 patients underwent early primary closure with post-operative continuous negative-pressure irrigation and drainage (intervention group).Baseline characteristics, clinical outcomes, and wound healing trajectories were analyzed. Time to wound healing was evaluated using Kaplan-Meier analysis and Cox proportional hazards models. Multivariable logistic regression analyses were performed to assess wound healing within 14 and 28 days after adjustment for potential confounders.

RESULTS

Patients in the intervention group exhibited a significantly shorter median wound healing time compared with controls (17.5 vs. 24.5 days, P = 0.003). The cumulative probability of wound healing was significantly higher in the intervention group(log-rank P = 0.003), and this association remained significant after multivariable adjustment (adjusted HR = 3.17, 95% CI: 1.66-6.05). Although no significant difference in healing within 14 days was observed after adjustment, the intervention was associated with a higher likelihood of complete wound healing within 28 days (adjusted OR = 11.63, 95% CI: 1.06-127.72). In addition, the intervention was associated with faster wound area reduction and better early wound cosmetic scores.

CONCLUSIONS

A multimodal strategy consisting of early primary closure supported by continuous negative-pressure irrigation and drainage was associated with accelerated wound healing and improved early wound appearance. E-value analysis suggested that unmeasured confounding is unlikely to fully explain the observed association, though residual confounding from selection bias cannot be excluded.No increase in adverse events was observed. Due to the retrospective design and relatively small sample size, these findings are hypothesis-generating. Prospective randomized trials are required to establish definitive clinical recommendations.