title: Closed Incision Negative-Pressure Therapy Is Associated with Decreased Surgical-Site Infections: A Meta-Analysis.
abstract: BACKGROUND
  Negative-pressure therapy has recently been used over closed incisions to decrease surgical-site occurrences, including infection and dehiscence. A meta-analysis was performed to evaluate the effectiveness of closed incision negative-pressure therapy in lowering the incidence of surgical-site infections compared with standard dressings.
  
  
  METHODS
  A literature search was conducted to find publications comparing closed incision negative-pressure therapy to standard incisional care. A fixed-effects model was used to assess between-study and between-incision location subgroup heterogeneity and effect size. Funnel plots were used to assess publication bias.
  
  
  RESULTS
  The overall weighted average rates of surgical-site infection in the closed incision negative-pressure therapy and control groups were 6.61 percent and 9.36 percent, respectively. This reflects a relative reduction in surgical site infection rate of 29.4 percent. A decreased likelihood of surgical-site infection was evident in the closed incision negative-pressure therapy group compared with the control group across all studies, and across all four incision location subgroups. Across all studies, odds of surgical-site infections decreased 0.564 (p < 0.00001). After excluding groin incision studies because of heterogeneity following sensitivity analysis, the odds of surgical-site infection decrease was still 0.496 (p < 0.00001). In addition, overall rates of dehiscence in closed incision negative-pressure therapy and control groups were 5.32 percent and 10.68 percent, respectively.
  
  
  CONCLUSIONS
  The results of this meta-analysis suggest that closed incision negative-pressure therapy is a potentially effective method for reducing surgical-site infections. It also appears that closed incision negative-pressure therapy may be associated with a decreased incidence of dehiscence, but the published data available were too heterogeneous to perform meta-analysis.
authors: Bethesda and Baltimore, Md.; and Chicago, Ill. From the Division of Plastic Surgery, University of Maryland School of Medicine; the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital; the Department of General Surgery, Walter Reed National Military Medical Center at Bethesda; and the University of Illinois at Chicago College of Medicine.
authors: Nina N
authors: NN
authors: Semsarzadeh
authors: Kashyap K
authors: KK
authors: Tadisina
authors: John
authors: J
authors: Maddox
authors: Karan
authors: K
authors: Chopra
authors: Devinder P
authors: DP
authors: Singh
mesh_terms: D006801:Humans; D015994:Incidence; D015233:Models, Statistical; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*