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World Journal of Surgery
Published in: World Journal of Surgery 5/2020

01-05-2020 | Wound Dehiscence | Scientific Review

The Efficacy of Prophylactic Negative Pressure Wound Therapy for Closed Incisions in Breast Surgery: A Systematic Review and Meta-Analysis

Authors: David Cagney, Lydia Simmons, Donal Peter O’Leary, Mark Corrigan, Louise Kelly, M. J. O’Sullivan, Aaron Liew, Henry Paul Redmond

Published in: World Journal of Surgery | Issue 5/2020

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Abstract

Background

Negative pressure wound therapy (NPWT) is a promising advance in the management of closed surgical incisions. NPWT application induces several effects locally within the wound including reduced lateral tension and improving lymphatic drainage. As a result, NPWT may improve wound healing and reduce surgical site complications. We aim to evaluate the efficacy of prophylactic application of NPWT in preventing surgical site complications for closed incisions in breast surgery.

Methods

This systematic review was reported according to PRISMA guidelines. The protocol was published in PROSPERO (CRD42018114625). Medline, Embase, CINAHL and Cochrane Library databases were searched for studies which compare the efficacy of NPWT versus non-NPWT dressings for closed incisions in breast surgery. Specific outcomes of interest were total wound complications, surgical site infection (SSI), seroma, haematoma, wound dehiscence and necrosis.

Results

Seven studies (1500 breast incisions in 904 patients) met the inclusion criteria. NPWT was associated with a significantly lower rate of total wound complications [odds ratio (OR) 0.36; 95% CI 0.19–069; P = 0.002], SSI (OR 0.45; 95% CI 0.24–0.86; P = 0.015), seroma (OR 0.28; 95% CI 0.13–0.59; P = 0.001), wound dehiscence (OR 0.49; 95% CI 0.32–0.72; P < 0.001) and wound necrosis (OR 0.38; 95% CI 0.19–0.78; P = 0.008). There was no significant difference in haematoma rate (OR 0.8; 95% CI 0.19–3.2; P = 0.75). Statistically significant heterogeneity existed for total wound complications, but no other outcomes.

Conclusion

Compared with conventional non-NPWT dressings, prophylactic application of NPWT is associated with significantly fewer surgical site complications including SSI, seroma, wound dehiscence and wound necrosis for closed breast incisions.
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Metadata
Title
The Efficacy of Prophylactic Negative Pressure Wound Therapy for Closed Incisions in Breast Surgery: A Systematic Review and Meta-Analysis
Authors
David Cagney
Lydia Simmons
Donal Peter O’Leary
Mark Corrigan
Louise Kelly
M. J. O’Sullivan
Aaron Liew
Henry Paul Redmond
Publication date
01-05-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 5/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05335-x

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