Abstract
BACKGROUND: Despite advances in surgical technique, ventral hernia repair (VHR) remains associated with significant postoperative wound complications. OBJECTIVE: A systematic review and meta-analysis was performed to identify whether the application of negative pressure wound therapy to closed incisions (iNPWT) following VHR reduces the risk of postoperative wound complications and hernia recurrence. METHODS: The PubMed/MEDLINE, EMBASE and SCOPUS databases were searched for studies published through October 2015. Publications that met the following criteria were included: adult patients undergoing VHR; comparison of iNPWT with conventional dressings; and documentation of wound complications and/or hernia recurrence. The methodological quality of included studies was independently assessed using the Methodological Index for Non-Randomized Studies guidelines. Outcomes assessed included surgical site infection (SSI), wound dehiscence, seroma, and hernia recurrence. Meta-analysis was performed to obtain pooled ORs. RESULTS: Five retrospective cohort studies including 477 patients undergoing VHR were included in the final analysis. The use of iNPWT decreased SSI (OR 0.33 [95% CI 0.20 to 0.55]; P<0.0001), wound dehiscence (OR 0.21 [95% CI 0.08 to 0.55]; P=0.001) and ventral hernia recurrence (OR 0.24 [95% CI 0.08 to 0.75]; P=0.01). There was no statistically significant difference in the incidence of seroma formation (OR 0.59 [95% CI 0.27 to 1.27]; P=0.18). CONCLUSION: For patients undergoing VHR, current evidence suggests a decreased incidence in wound complications using incisional NPWT compared with conventional dressings.
Original language | English (US) |
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Pages (from-to) | 113-118 |
Number of pages | 6 |
Journal | Canadian Journal of Plastic Surgery |
Volume | 24 |
Issue number | 2 |
DOIs | |
State | Published - Jun 1 2016 |
Keywords
- Abdominal wall reconstruction
- Closed incision
- Hernia recurrence
- Negative pressure wound therapy
- Seroma
- Surgical site infection
- Vacuum-assisted closure
- Ventral hernia repair
- Wound complications
- Wound dehiscence
ASJC Scopus subject areas
- Surgery