Effectiveness of Open Incision Negative Pressure Wound Therapy for Surgical Site Infection Prevention for Abdominal Surgery-A Systematic Review and Meta-Analysis.

Open incision negative pressure wound therapy (NPWT) combines delayed closure with negative pressure to prevent surgical site infection (SSI). Its effectiveness in preventing SSI remains unclear, complicating its risk-benefit assessment. PubMed and Web of Science databases were searched for relevant English studies. Two reviewers independently screened titles and abstracts using the ASReviewer tool. Full-text articles were assessed for eligibility. Eight studies were included in the systematic review and five were pooled in the meta-analysis. Data extraction followed the PRISMA guidelines, and the risk of bias was assessed. A meta-analysis was performed using a random-effects model for SSI occurrence. Eight studies (three RCTs and five cohort studies) with 1655 patients were included. Studies were pooled based on control interventions: primary closure (PC) or delayed primary closure (DPC). Pooled odds ratio (OR) estimates favoured NPWT over PC for SSI reduction (OR, 0.15; 95% CI, 0.02-0.87). No significant SSI risk difference was found between the NPWT and DPC groups (OR, 0.28; 95% CI, 0.06-1.27). Preventive NPWT is associated with a reduced risk of SSI in abdominal surgery compared to PC. Our findings indicate that standardising treatment and reporting protocols could improve future evaluations of NPWT effectiveness. Trial Registration: PROSPERO identifier: CRD42024401669.