Effect of Negative Pressure Wound Therapy on Surgical Site Infections following Stoma Reversal in Colorectal Surgery: A Meta-Analysis

Abstract

Background

Surgical site infections (SSI) are common complications after surgery, which cause other complications and increase medical costs. However, the effect of negative-pressure wound therapy (NPWT) for the prevention of SSI at stoma reversal remains inconclusive, with controversial results. This meta-analysis aimed to evaluate the safety and efficacy of NPWT following stoma reversal in colorectal surgery to prevent SSI and other wound complications.

Methods

We conducted a systematic search of the PubMed, EMBASE, and Cochrane Library databases for articles published up to July 2022 and identified relevant studies reporting the NPWT administration following stoma reversal in colorectal surgery compared with non-pressure dressing. The primary outcome was the incidence of SSI, and the secondary outcomes were hematoma, seroma, and length of hospital stay (LOS).

Results

Nine studies were included in the meta-analysis, with 825 patients with (n = 310) or without (n = 515) NPWT. Pooled SSI rate was lower in the NPWT group than in the non-pressure dressing group (OR = 0.50; 95% CI: 0.29, 0.84; P = 0.01). There was no significant effect on hematoma (OR = 0.21; 95% CI: 0.03, 1.27; P = 0.09), seroma (OR = 0.26; 95% CI: 0.05, 1.28; P = 0.1) and LOS (MD = −0.16, 95% CI: −0.83, 0.51; P = 0.64).

Conclusion

The use of NPWT following stoma reversal in colorectal surgery reduced the incidence of SSI. However, this conclusion needs to be interpreted with caution, and further studies should be conducted to confirm in higher-quality RCTs.

Keywords:

• Colorectal surgery
• stoma reversal
• surgical site infection
• negative-pressure wound therapy
• NPWT

Author contribution

JZ and QS designed the paper. Data gathering was completed by WX, JG and QF. Data analysis was completed by JZ, SL and ZZ. JZ and QS drafted the manuscript. SL and ZZ accomplished the manuscript revision. All authors read and approved the final manuscript. Junjia Zhu and Qi Sun contributed equally to this paper and were co-first authors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by Youth Research Project Fund of Wuxi Municipal Health Commission (NO.Q201949); Wuxi ‘Taihu Lake talent plan’ medical and health high level talent project, NO2020103; Wuxi precision medicine project, J202009.