This systematic review and meta-analysis evaluated incisional negative pressure wound therapy (iNPWT) vs standard dressings for preventing surgical site infection (SSI) in adults undergoing surgery, searching PubMed, Embase, and CENTRAL through March 7, 2026.
Across 85 RCTs (n=16,980), iNPWT reduced overall SSI (RR 0.64), deep SSI (RR 0.66), superficial SSI (RR 0.59), wound dehiscence (RR 0.73), seroma (RR 0.77), reoperation (RR 0.80), and skin necrosis (RR 0.38); however, it increased skin blistering (RR 4.51; NNH=18) and device-related adverse events (RR 11.87; NNH=11), with an NNT of 21 for SSI prevention.
- Certainty of evidence was only moderate, limiting confidence in effect sizes. - Organ-space SSI, readmission, and mortality showed no significant benefit, and subgroup heterogeneity across surgical contexts was not fully resolved. - Full text was not publicly available (embargoed until 2027), so risk-of-bias details across all 85 trials could not be independently assessed here.
Consider iNPWT selectively for patients at elevated risk of incisional wound complications rather than applying it routinely, balancing its SSI-reduction benefit (NNT=21) against meaningful risks of skin blistering and device-related adverse events (NNH=11–18).
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