What’s better: negative-pressure wound therapy or standard surgical dressings?

By Shahzadi Adeena, Class of 2025

Figure 1: Health professional holding rolled out gauze

Doctors seek to improve post-operative care, as it is a critical aspect of surgery that determines success or infection. Following a surgical procedure, it is routine to apply standard surgical dressings (SSDs) on patients to promote healing and prevent infection. Modern surgical dressings are usually gauze dressings made of cotton, rayon, and polyester fibers. Physicians and researchers in the Division of Plastic and Reconstructive Surgery and Orthopedic Oncology at the Stony Brook Renaissance School of Medicine conducted a study examining the outcomes of negative-pressure wound therapy (NPWT) in comparison to standard surgical dressings after malignant tumor resections. NPWT utilizes  sub-atmospheric pressure to seal surgical wounds and reduce inflammation. The team hypothesized that there would be no significant difference in the post-operative outcome whether NPWT or SSD was used. 

This study was a systematic literature review, drawing from research databases such as Pubmed, Embase, CINAHL, and Cochrane Central. In total, 1634 studies were chosen for an initial screening. After identifying duplicates and scanning abstracts, 121 studies proceeded to full screening, of which 27 were identified as eligible for meta-analysis. In these studies, 1124 participants received NPWT and 1392 participants received SSD. Data from these 27 studies was compiled and subject to meta-analysis, which compared the surgical outcomes of using either negative-pressure wound therapy or standard surgical dressings after the same procedure of malignant tumor resection. Specifically, the researchers compared the recurrence of the malignancy after surgery, wound complication, and surgical site infection rates. This was done through a random effects meta-analysis model, which accounts for differences between studies due to varying treatments of patients. The meta-analysis demonstrated that NPWT had statistically significant lower surgical site infection and wound complication rates. However, there was no statistically significant difference in the recurrence of malignancy between NPWT and SSD. 

The researchers’ analysis suggests favorable outcomes for wounds due to malignant tumor resections when utilizing negative-pressure wound therapy compared to standard surgical dressings. However, this analysis was limited by the small number of randomized controlled trials available; the studies analyzed focused primarily on incisional wounds to particular body parts. Future research can be improved by involving more studies and compiling a larger dataset for meta-analysis. Nevertheless, increased use of negative-pressure wound therapy after surgery is promising for lowering rates of surgical site infections and wound complicated rates, improving the quality of healthcare for patients. 

Works Cited:

[1] T. R. Hays, et al., Negative-Pressure Wound Therapy Versus Standard Surgical Dressings After Malignant Tumor Resection: A Systematic Review and Meta-Analysis. Plastic and Reconstructive Surgery 150, (2022). doi: 10.1097/PRS.0000000000009448

[2] Image retrieved from:

https://www.pexels.com/photo/person-holding-a-rolled-gauze-7468920/

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