Meta-Analysis of Comparative Trials Evaluating a Single-Use Closed-Incision Negative-Pressure Therapy System

Devinder P. Singh, Allen Gabriel, Javad Parvizi, Michael J. Gardner, Ralph D'Agostino

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

BACKGROUND: Surgical site infections (SSIs) pose a significant surgical complication. Application of closed-incision negative-pressure therapy (ciNPT) has been associated with reduced SSI rates in published literature. This meta-analysis examines the effect of ciNPT use over closed incisions in reducing SSIs versus traditional dressings. METHODS: A systematic literature search using PubMed, The Cochrane Library, OVID, EMBASE, ScienceDirect, and QUOSA was performed focusing on publications between January 1, 2005, and April 30, 2018. Characteristics of study participants, surgical procedure, type of dressing used, duration of treatment, incidence of SSI, and length of follow-up were extracted. Weighted odds ratios and 95% CIs were calculated to pool study and control groups in each publication for analysis. Treatment effects were combined using Mantel-Haenszel odds ratios as the summary statistics, and a fixed-effects model was used for each analysis performed. The chi-square test was used to statistically assess heterogeneity. For each meta-analysis performed, the more conservative random-effects models were conducted as sensitivity analyses. RESULTS: For all meta-analyses (randomized controlled trial only, observational studies only, colorectal/abdominal, obstetrics, lower extremity, groin/vascular, cardiac), heterogeneity tests were nonsignificant (P > 0.05). All fixed-effects meta-analyses were significant in favor of ciNPT use over traditional dressings (P < 0.05). When the random-effects analyses were performed, all analyses except obstetrics remained significant (P < 0.05). CONCLUSION: For all meta-analyses performed using the fixed-effects approach, ciNPT usage demonstrated a statistically significant reduction in incidence of SSI relative to traditional dressings.

Original languageEnglish (US)
Pages (from-to)41S-46S
JournalPlastic and reconstructive surgery
Volume143
Issue number1 Management of Surgical Incisions Utilizing ClosedIncision N...
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Meta-Analysis of Comparative Trials Evaluating a Single-Use Closed-Incision Negative-Pressure Therapy System'. Together they form a unique fingerprint.

Cite this