The prophylactic use of negative pressure wound therapy after cardiac surgery: a meta-analysis

Background Surgical site infections (SSi) pose a frequent complication in cardiac surgery patients and lead to increased patient discomfort and extended hospitalization. Aim This meta-analysis evaluates the protective role of single-use-negative-pressure-wound-therapy (sNPWT) devices on closed surgical wounds after cardiac surgery, and explores their potential preventive application across all cardiac surgery patients. Methods A comprehensive literature search was conducted on PubMed and Elsevier, focusing on studies related to "negative pressure wound therapy" or "PICO negative pressure wound therapy" combined with "cardiac surgery" or "sternotomy," published between 2000 and 2022. Inclusion criteria encompassed case-control studies comparing sNPWT with traditional dressing on closed cardiac surgical incisions in adult patients undergoing median sternotomy without immediate postoperative infective complications, with available details on SSIs.A retrospective analysis of cases treated with sNPWT in our Center was also performed. Findings The meta-analysis revealed a protective role of sNPWT, indicating a 44% risk reduction in overall SSIs (OR 0.56) and a 40% risk reduction in deep wound infections (OR 0.60). Superficial wound infections, however, showed non-significant protective effects. A single-center study aligned with the meta-analysis findings, confirming the efficacy of sNPWT and was included in the meta-analysis. Conclusion The meta-analysis and the single-centre study collectively support the protective role of negative pressure wound therapy against overall and deep surgical site infections, suggesting its potential prophylactic use on all cardiac surgery population.