Efficacy of prophylactic negative pressure wound therapy after open ventral hernia repair: a systematic review meta-analysis

• Published in: BMC surgery Vol. 23; no. 1; p. 374
• Main Authors: Xu, Yang, Shao, Shuai, Gong, ZeZhong, Ri, HyokJu, Xu, ZhaoHui, Kang, HaoNan, Shan, Yan, Amadou, Boureima Hamidou, Ren, YanYing, Zhang, Fan, Chen, Xin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.12.2023; BioMed Central; BMC
• Subjects: Abdomen; Analysis; Bias; Clinical trials; Cohort analysis; Complications and side effects; Data collection; Dehiscence; Effectiveness; Hematoma; Hernia; Hernias; Infectious diseases; Medical research; Medicine, Experimental; Meta-analysis; Necrosis; NPWT; OVHR; Review; Skin; Software; Surgery; Surgical site infections; Surgical site occurrences; Systematic review; Ventral hernia; Wound dehiscence; Wound healing; Wounds; United States > US; NPWT; OVHR; Surgical site occurrences; Ventral hernia
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-023-02280-4

The susceptibility to surgical site occurrence (SSO) is high following ventral hernia repair (VHR) surgery. SSO severely increases the physical and mental burden on patients. The main purpose of this review was to analyze the efficacy of negative pressure wound therapy (NPWT) after open VHR(OVHR) and explore benefits to patients. The Cochrane Library, PubMed, and Embase databases were searched from the date of establishment to 15 October 2022. All randomized controlled trials and retrospective cohort studies comparing NPWT with standard dressings after OVHR were included. The Revman 5.4 software recommended by Cochrane and the STATA16 software were used in this meta-analysis. Fifteen studies (involving 1666 patients) were identified and included in the meta-analysis, with 821 patients receiving NPWT. Overall, the incidence rate of SSO in the NPWT group was lower compared to the control group (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.21-0.93; I  = 86%; P = 0.03). The occurrence rate of surgical site infection (SSI; OR = 0.51; 95% CI = 0.38-0.68, P < 0.001), wound dehiscence (OR = 0.64; 95% CI = 0. 43-0.96; P = 0.03), and hernia recurrence (OR = 0.51; 95% CI = 0.28-0.91, P = 0.02) was also lowered. There was no significant difference in seroma (OR = 0.76; 95% CI = 0.54-1.06; P = 0.11), hematoma (OR = 0.53; 95% CI = 0.25-1.11; P = 0.09), or skin necrosis (OR = 0.83; 95% CI = 0.47-1.46; P = 0.52). NPWT can effectively decrease the occurrence of SSO, SSI wound dehiscence and hernia recurrence and should be considered following OVHR.