Meta-analysis of negative pressure wound therapy of closed groin incisions in arterial surgery
(2020) In British Journal of Surgery 106(4). p.310-318- Abstract
Background: Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. Methods: A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full... (More)
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Background: Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. Methods: A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full text by two of the authors independently. The selected articles were rated for bias according to the Cochrane risk-of-bias tool. Results: Among 1567 records generated by the search, seven RCTs were identified, including 1049 incisions. Meta-analysis showed a reduction in SSI with incisional NPWT (odds ratio (OR) 0·35, 95 per cent c.i. 0·24 to 0·50; P < 0·001). The heterogeneity between the included studies was low (I
2
= 0 per cent). The quality of evidence was graded as moderate. Two studies had multiple domains in the Cochrane risk-of-bias tool rated as high risk of bias. A subgroup meta-analysis of three studies of lower limb revascularization procedures only (363 incisions) demonstrated a similar reduction in SSI (OR 0·37, 0·22 to 0·63; P < 0·001; I
2
= 0 per cent). Conclusion: Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis.
- author
- Svensson-Björk, R. LU ; Zarrouk, M. LU ; Asciutto, G. LU ; Hasselmann, J. LU and Acosta, S. LU
- organization
- publishing date
- 2020-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Surgery
- volume
- 106
- issue
- 4
- pages
- 9 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85061342567
- pmid:30725478
- ISSN
- 0007-1323
- DOI
- 10.1002/bjs.11100
- project
- Negative pressure wound therapy in closed inguinal incisions after vascular surgery – randomized controlled trials
- language
- English
- LU publication?
- yes
- id
- b599b5da-eb29-4d74-9284-52c6ef412d1f
- date added to LUP
- 2019-02-19 12:20:02
- date last changed
- 2024-07-23 09:53:56
@article{b599b5da-eb29-4d74-9284-52c6ef412d1f, abstract = {{<p><br> Background: Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. Methods: A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full text by two of the authors independently. The selected articles were rated for bias according to the Cochrane risk-of-bias tool. Results: Among 1567 records generated by the search, seven RCTs were identified, including 1049 incisions. Meta-analysis showed a reduction in SSI with incisional NPWT (odds ratio (OR) 0·35, 95 per cent c.i. 0·24 to 0·50; P < 0·001). The heterogeneity between the included studies was low (I <br> <sup>2</sup><br> = 0 per cent). The quality of evidence was graded as moderate. Two studies had multiple domains in the Cochrane risk-of-bias tool rated as high risk of bias. A subgroup meta-analysis of three studies of lower limb revascularization procedures only (363 incisions) demonstrated a similar reduction in SSI (OR 0·37, 0·22 to 0·63; P < 0·001; I <br> <sup>2</sup><br> = 0 per cent). Conclusion: Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis. <br> </p>}}, author = {{Svensson-Björk, R. and Zarrouk, M. and Asciutto, G. and Hasselmann, J. and Acosta, S.}}, issn = {{0007-1323}}, language = {{eng}}, number = {{4}}, pages = {{310--318}}, publisher = {{Oxford University Press}}, series = {{British Journal of Surgery}}, title = {{Meta-analysis of negative pressure wound therapy of closed groin incisions in arterial surgery}}, url = {{http://dx.doi.org/10.1002/bjs.11100}}, doi = {{10.1002/bjs.11100}}, volume = {{106}}, year = {{2020}}, }