Table 1.

Characteristics of included studies

Reference	Country	No. of incisions	Type of surgery	Treatment*	Inclusion and exclusion criteria	Outcome measures†	Follow‐up
Howell et al.33	USA	60	Total knee arthroplasty	VAC® versus sterile gauze (dressing not described) (all wounds were assessed after 48 h)	Inclusion: BMI ≥ 30 kg/m2 and enoxaparin sodium for DVT	Primary: days to a dry wound (no drainage on gauze for 24 h)	12 months
					Exclusion: revision total knee replacement, previous knee surgery and documented diabetes	Secondary: total wound drainage, no. of gauze dressings applied to the wound, duration of hospital stay, incidence of infection, readmission
Pachowsky et al.34	Germany	19	Total hip arthroplasty	Prevena™ versus ‘a dry wound coverage’ (dressing not described) (5 days versus n.s.)	n.s.	Primary: seroma (ultrasound imaging of the wound was used to show a seroma)	10 days
Grauhan et al.35	Germany	150	Median sternotomy	Prevena™ versus conventional wound dressings (dressing not described) (6–7 days versus 1–2 days)	Inclusion: BMI ≥ 30 kg/m2, and absence of preoperative signs of inflammation Exclusion: immunological disease, immunosuppressive therapy, skin disease	Primary: wound infection (defined according to US Centers for Disease Control and Prevention criteria)	90 days
						Secondary: dehiscence of skin or sternum
Masden et al.36	USA	81	Primary or delayed primary closure of lower extremity or abdominal wounds	VAC® versus standard dry sterile dressing (Mepitel®) and a bacteriostatic single silver layer (Acticoat™) (all wounds assessed on day 3)	Inclusion: scheduled to undergo primary or delayed primary closure	Primary: wound infection, wound dehiscence (evaluated by a member of the research team, blinded to randomization groups)	Average of 113 days
					Exclusion: patients allergic to tape or who could not tolerate NPWT; patients with lower‐extremity amputations distal to forefoot
						Secondary: reoperation, duration of hospital stay
Stannard et al.37	USA	263	High‐risk lower extremity fractures (tibial plateau, pilon, calcaneus)	VAC® versus standard postoperative dressing (dressing not described) (all wounds assessed on day 2)	Inclusion: presence of a high‐energy tibial plateau, pilon or calcaneus fractures	Primary: wound infection (defined with a combination of clinical signs and symptoms and laboratory data), wound dehiscence (defined as any separation of the incision that required wound care or reoperation)	n.s.
					Exclusion: non‐operative or open fractures, receiving definitive surgery more than 16 days after injury, pregnant women and patients with low‐energy fractures
Pauser et al.38	Germany	21	Hemiathroplasty	Prevena™ versus ‘a dry wound coverage’ (dressing not described) (5 days versus n.s.)	n.s.	Primary: seroma (ultrasound imaging of the wound was used to show a seroma)	10 days
Nordmeyer et al.39	Germany	20	Spinal fracture	PICO™ versus ‘a dry wound coverage’ (dressing not described) (5 days versus n.s.)	n.s.	Primary: seroma (ultrasound imaging of the wound was used to show a seroma)	10 days
B. D. Crist et al. (personal communication)	USA	90	Pelvic, acetabular and hip fractures	VAC® versus a standard gauze (dressing not described) (all wounds assessed on day 2)	Inclusion: age 18 years or older, scheduled for surgical repair of pelvic and/or acetabular fracture, and subject/guardian able to provide informed consent	Primary: deep wound infection (‘Deep infection was one that went to the OR’) Secondary: wound drainage, duration of hospital stay, dressing supply costs, nursing time cost for dressing changes	12 months
					Exclusion: pregnancy, injury treated percutaneously without open surgery
S. Karlakki et al. (personal communication)	UK	209	Hip and knee replacement	PICO™ versus Mepore® or Tegaderm™ + Pad (3 M) (7 days versus 2 days)	Exclusion: known allergies to dressings, and those on warfarin	Primary: exudate from the surgical wound (predefined grading of wound exudate)	6 weeks
						Secondary: wound complications, readmissions, no. of dressing changes, overall cost‐effectiveness
R. Galiano et al. (personal communication)	USA, South Africa, France and the Netherlands	398	Bilateral breast reduction	PICO™ versus Steri‐Strip™ (7 days versus 7 days)	n.s.	Primary: delayed healing, dehiscence, wound infection (predefined description of primary outcome not stated)	21 days
						Secondary: scar quality	90 days

Text in parentheses indicates

^*duration of treatment before first dressing change and

^†predefined description of primary outcome. Mepitel™ (Mölnlycke Health Care, Gothenburg, Sweden); Acticoat™ (Smith & Nephew, Hull, UK); Mepore® (Mölnlycke Health Care); Tegaderm™ (3 M, St Paul, Minnesota, USA); Steri‐Strip™ (3 M). BMI, body mass index; DVT, deep vein thrombosis; n.s., not stated; NPWT, negative‐pressure wound therapy; OR, operating room.