Meta-analysis of negative pressure wound therapy of closed groin incisions in arterial surgery.
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
01
10
2018
revised:
14
10
2018
accepted:
30
11
2018
pubmed:
7
2
2019
medline:
7
9
2019
entrez:
7
2
2019
Statut:
ppublish
Résumé
Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full text by two of the authors independently. The selected articles were rated for bias according to the Cochrane risk-of-bias tool. Among 1567 records generated by the search, seven RCTs were identified, including 1049 incisions. Meta-analysis showed a reduction in SSI with incisional NPWT (odds ratio (OR) 0·35, 95 per cent c.i. 0·24 to 0·50; P < 0·001). The heterogeneity between the included studies was low (I Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis.
Sections du résumé
BACKGROUND
Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery.
METHODS
A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full text by two of the authors independently. The selected articles were rated for bias according to the Cochrane risk-of-bias tool.
RESULTS
Among 1567 records generated by the search, seven RCTs were identified, including 1049 incisions. Meta-analysis showed a reduction in SSI with incisional NPWT (odds ratio (OR) 0·35, 95 per cent c.i. 0·24 to 0·50; P < 0·001). The heterogeneity between the included studies was low (I
CONCLUSION
Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis.
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
310-318Informations de copyright
© 2019 BJS Society Ltd. Published by John Wiley & Sons Ltd.