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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2023; 13(02): 063-067
DOI: 10.1055/s-0043-1771452
Systematic Review

Systematic Review and Meta-Analysis: Role of Negative Pressure Wound Therapy in Preventing Surgical Site Infections after Pancreaticoduodenectomy

Harjeet Singh
1   Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Santosh Irrinki 
2   Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Gautham Krishnamurthy 
3   Department of Surgical Gastroenterology, SRM Institute of Medical Sciences, Chennai, Tamil Nadu, India
,
Kailash Kurdia
4   Department of Gastrointestinal Surgery, All India Institute of Medical Education Research, New Delhi, India
› Author Affiliations Funding None.
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Abstract

Background Surgical site infection (SSI) after pancreaticoduodenectomy is associated with significant morbidity, increased hospital stays, delay in adjuvant treatment, and overburden on hospital resources. There is no consensus in the management of these wounds.

Methods We performed a systematic review. We searched the PubMed, Embase, and Scopus on March 23, 2022 for studies reporting on negative pressure wound therapy (NPWT) in patients operated on with pancreaticoduodenectomy. We included all studies that reported the comparative outcomes of NPWT in patients undergoing pancreaticoduodenectomy. All data were extracted by two reviewers separately. The pooled odds risk of SSI was calculated using the metabin command and Mantel–Haenszel approach.

We assessed the risk of bias using Joanna Briggs Institute's critical appraisal tool for cohort studies.

Results Four studies with 878 participants were included. The pooled odds ratio for SSI was lower in the NPWT group as compared with standard care (0.36; 95% confidence interval [CI]: 0.24–0.54; I 2 = 0). The pooled odds ratio of organ space infection was 0.40 (95% CI: 0.24–0.67; I 2 = 0) on the basis of three studies (484 participants). We did not perform any subgroup analyses because of lack of heterogeneity in the reported results and limited number of studies.

Conclusion Pancreaticoduodenectomy is associated with high risk of SSI. The use of prophylactic NPWT after pancreaticoduodenectomy is associated with decreased risk of SSI. The cost–benefit ratio of NPWT over standard care requires further comparative study.

Keywords

wound infection - SSI - negative pressure wound therapy - pancreaticoduodenectomy - surgery

Ethical Statement

Not applicable.


Data Availability Statement

Data from this study are available from the corresponding author upon reasonable request.


Authors' Contribution

All authors contributed equally to the article.


Supplementary Material



Publication History

Received: 27 May 2023

Accepted: 19 June 2023

Article published online:
13 October 2023

© 2023. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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