Table. Characteristics of Included Studies.
| Source/Country/Study Type | No. of Patients, NPWT/Control Groups | Relevant Outcome (Time Measured) | Wound Categories | Details of NPWTa | Type of Procedure | Antibiotic Therapy | Mechanical Bowel Preparation | Follow-up | Downs and Black Scoreb |
|---|---|---|---|---|---|---|---|---|---|
| Bonds et al,35 2013/United States/ retrospective | 32/222 | SSI | Contaminated/dirty (28% NPWT vs 26% control wounds) | VAC (setting, −75 mm Hg) used for 5 to 7 d with foam dressing (Granufoam; KCI) | Emergency (9% NPWT vs 27% control wounds) and elective (15% NPWT vs 85% control wounds) | Not mentioned | Not mentioned | Not specified | 26 |
| Pellino et al,34 2014/ Italy/prospective | 50/50 (25 Colorectal NPWT and 25 colorectal standard dressings) |
Infectious surgical site events (30 d) and LOS | Not mentioned | PICO (setting, −80 mm Hg) used for 7 d | Not mentioned | Not mentioned | Not mentioned | 90 d | 26 |
| Selvaggi et al,33 2014/Italy/prospective | 25/25 | Seroma, infectious surgical site events (30 d), and LOS | Not mentioned | PICO (setting, −80 mm Hg) used for 7 d | Not mentioned | All patients received intraoperative IV cefotaxime, 1 g, and metronidazole, 500 g, and continued therapy postoperatively as required | Not mentioned | 90 d | 28 |
| Lozano-Balderas et al,32 2017/Mexico/RCT | 25/27 (An additional 29 patients underwent DPC in a 3-arm trial) | SSI (30 d) | Contaminated (48% NPWT vs 33% control wounds) and dirty (52% NPWT vs 67% control) wounds | VAC (setting or duration not stated) used | All emergency | Cephalosporin antibiotic and metronidazole | Not mentioned | 30 d | 31 |
| O’Leary et al,30 2017/Ireland/RCT | 25/25 | SSI (4 and 30 d) and LOS | Clean (21% NPWT vs 24% control wounds), clean contaminated (71% NPWT vs 68% control wounds), and dirty (8.3% NPWT vs 8% wounds) | PICO (setting, −80 mm Hg) for 4 d | Elective and emergency | All patients received 1.2 g IV combined amoxicillin and clavulanate potassium (Augmentin) at induction; 2 further postoperative doses for clean contaminated or contaminated wounds only | No | 30 d | 29 |
| Zaidi and El-Masry,38 2017/Ireland/retrospective | 69/112 | Deep incisional wound infection or dehiscence (30 d) | Clean contaminated and contaminated (no breakdown provided) | PREVENA (setting, −125 mm Hg) for 7 d | Elective (70% NPWT vs 73% control wounds) and emergency (30% NPWT vs 27% control wounds) | Not mentioned | Not mentioned | 30 d | 26 |
| Schurtz et al,37 2018/United States/retrospective | 48/48 | SSI (30 d) | Clean (23% NPWT vs 29% control wounds), clean contaminated (39% NPWT vs 42% control wounds), and contaminated (37% NPWT vs 29% control wounds) | PREVENA (setting, −125 mm Hg) for 4 to 8 d | All emergency laparotomies | All patients received preoperative antibiotics (no details) | No | 30 d | 25 |
| Blackham et al,36 2013/United States/retrospective | 104/87 | SSI (30 d), seroma formation, and wound dehiscence | Clean (4% NPWT vs 29% control wounds), clean contaminated (96% NPWT vs 71% control wounds) | VAC (setting, −125 mm Hg) for 4 d | All elective | Preoperative antibiotics at induction (not continued postoperatively) | Yes | 30 d | 25 |
| Shen et al,31 2017/United States/RCT | 132/133 | SSI (30 d), seroma formation, and wound dehiscence | All were clean contaminated | VAC (setting, −125 mm Hg) for 4 d | All elective | Not explicitly mentioned | Not mentioned | 30 d | 31 |
Abbreviations: DPC, delayed primary closure; IV, intravenous; LOS, length of stay; NPWT, negative pressure wound therapy; RCT, randomized controlled trial; SSI, surgical site infection.
a
Devices include VAC (KCI), PREVENA (KCI), and PICO (Smith and Nephew).
b
The scale consists of 27 items evaluating study reporting and external and internal validity and power in randomized and nonrandomized studies, with a maximum assigned score of 32 (best assessment).18