Asia-Pacific journal of oncology nursing · 2025
Negative pressure wound therapy for preventing wound complications following stoma reversal: A systematic review and meta-analysis of randomized controlled trials.
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Li Siqing, Guan Xiaofang, Huang Xirong, Wang Zhong, Mo Linjie, Xie Minyi, Liu Yuxia, Luo Wenxin
Аннотация
OBJECTIVE: To evaluate the effectiveness of negative pressure wound therapy in preventing wound complications following colorectal stoma reversal and provide evidence-based recommendations for its clinical application.
METHODS: A comprehensive search was conducted across five English databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus) and three Chinese databases (Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang) from their inception to December 2024. Grey literature and trial registries were also included. Eligible studies were randomized controlled trials investigating negative pressure wound therapy for patients undergoing stoma reversal. Primary outcomes included wound complications (surgical site infections, hematoma, seroma); secondary outcomes comprised hospital stay, wound healing duration, and dressing costs.
RESULTS: Eight randomized trials involving 517 patients were included. Negative pressure wound therapy significantly reduced wound complications (odds ratio, 0.50; 95% confidence interval, 0.27-0.94), shortened wound healing time (mean difference, -4.31; 95% confidence interval, -4.97 to -3.65), and decreased hospital stay (mean difference, -1.05; 95% confidence interval, -1.70 to -0.41). Subgroup analysis demonstrated benefits in the linear closure group (odds ratio, 0.11; 95% confidence interval, 0.02-0.49) but not in the purse-string closure groups. No significant differences were observed in surgical site infections, hematoma, seroma, or dressing costs.
CONCLUSIONS: Negative pressure wound therapy reduces wound complications, accelerates wound healing, and shortens hospital stays after stoma reversal. Standardized protocols and additional high-quality trials are required to establish negative pressure wound therapy as a routine practice.
SYSTEMATIC REVIEW REGISTRATION: Prospectively registered in PROSPERO (ID CRD42023451001).
METHODS: A comprehensive search was conducted across five English databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus) and three Chinese databases (Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang) from their inception to December 2024. Grey literature and trial registries were also included. Eligible studies were randomized controlled trials investigating negative pressure wound therapy for patients undergoing stoma reversal. Primary outcomes included wound complications (surgical site infections, hematoma, seroma); secondary outcomes comprised hospital stay, wound healing duration, and dressing costs.
RESULTS: Eight randomized trials involving 517 patients were included. Negative pressure wound therapy significantly reduced wound complications (odds ratio, 0.50; 95% confidence interval, 0.27-0.94), shortened wound healing time (mean difference, -4.31; 95% confidence interval, -4.97 to -3.65), and decreased hospital stay (mean difference, -1.05; 95% confidence interval, -1.70 to -0.41). Subgroup analysis demonstrated benefits in the linear closure group (odds ratio, 0.11; 95% confidence interval, 0.02-0.49) but not in the purse-string closure groups. No significant differences were observed in surgical site infections, hematoma, seroma, or dressing costs.
CONCLUSIONS: Negative pressure wound therapy reduces wound complications, accelerates wound healing, and shortens hospital stays after stoma reversal. Standardized protocols and additional high-quality trials are required to establish negative pressure wound therapy as a routine practice.
SYSTEMATIC REVIEW REGISTRATION: Prospectively registered in PROSPERO (ID CRD42023451001).