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Prophylactic negative pressure wound therapy after open ventral hernia repair: a systematic review and meta-analysis

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A Comment to this article was published on 28 April 2022

Abstract

Purpose

Negative pressure wound therapy on closed incisions (iNPWT) is a wound dressing system developed to promote wound healing and avoid complications after surgical procedures. The effect of iNPWT is well established in various surgical fields, however, the effect on postoperative wound complications after ventral hernia repair remains unknown. The aim of this systematic review and meta-analysis was to investigate the effect of iNPWT on patients undergoing open ventral hernia repair (VHR) compared with conventional wound dressing.

Materials and methods

This systematic review and meta-analysis followed the PRISMA guidelines. The databases PubMed, Embase, Cochrane Library, Web of science and Cinahl were searched for original studies comparing iNPWT to conventional wound dressing in patients undergoing VHR. The primary outcome was surgical site occurrence (SSO), secondary outcomes included surgical site infection (SSI) and hernia recurrence.

Results

The literature search identified 373 studies of which 10 were included in the meta-analysis including a total of 1087 patients. Eight studies were retrospective cohort studies, one was a cross-sectional pilot study, and one was a randomized controlled trial. The meta-analysis demonstrated that iNPWT was associated with a decreased risk of SSO (OR 0.27 [0.19, 0.38]; P < 0.001) and SSI (OR 0.32 [0.17, 0.55]; P < 0.001). There was no statistically significant association with the risk of hernia recurrence (OR 0.62 [0.27, 1.43]; P = 0.26).

Conclusion

Based on the findings of this systematic review and meta-analysis iNPWT following VHR was found to significantly reduce the incidence of SSO and SSI, compared with standard wound dressing. INPWT should be considered for patients undergoing VHR.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author, VBH, upon reasonable request.

Code availability

Not applicable.

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Funding

No funding was received for the current study.

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Authors and Affiliations

  1. Digestive Disease Center, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark

    V. Berner-Hansen, E. Oma, M. Willaume & K. K. Jensen

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  1. V. Berner-Hansen
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  3. M. Willaume
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Contributions

All authors listed in this manuscript meet the authorship requirements set out by the International Committee of Medical Journal Editors (ICMJE). Conception and design were done by KKJ and EO. Literature search and data collection were by EO, MW and VBH. Analysis and interpretation were done by EO and VBH. VBH drafted the manuscript. Critical revision of the article was done by KKJ, EO, MW and VBH. All authors approved the final manuscript.

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Correspondence to V. Berner-Hansen.

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Drs. Berner-Hansen, Oma, Willaume and Jensen have no conflict of interest or financial ties to disclose.

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Berner-Hansen, V., Oma, E., Willaume, M. et al. Prophylactic negative pressure wound therapy after open ventral hernia repair: a systematic review and meta-analysis. Hernia 25, 1481–1490 (2021). https://doi.org/10.1007/s10029-021-02485-7

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