Focus of Report: The focus of this Health Technology Assessment is evaluation of the effectiveness and safety of negative pressure wound therapy (NPWT) compared with conventional surgical wound care for management of surgical incisions after total knee arthroplasty (TKA).

Technology Description: NPWT (also known as vacuum-assisted wound closure) is a therapeutic dressing system in which negative pressure is applied to the wound. The device comprises an occlusive dressing that is sealed over the wound and connected to drainage tubing coupled to a suction pump that delivers negative pressure of from −50 to −125 millimeters of mercury (mm Hg).

Controversy: Despite a growing body of evidence on prophylactic NPWT, there is a lack of consensus concerning its use after TKA for prevention of surgical wound complications. Conflicting evidence from higher-quality studies, including randomized controlled trials (RCTs), contributes to this controversy regarding efficacy and whether NPWT provides sufficient benefit for this indication.

Key Questions:

  • Is NPWT effective for promoting wound closure and preventing wound complications after TKA?

  • How does NPWT compare with established methods of surgical wound care after TKA?

  • Is NPWT for treatment of surgical sites after TKA safe?

  • Have definitive patient selection criteria been identified for management of surgical wounds with NPWT after TKA?

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