Focus of the Report: This report focuses on the use of prophylactic negative pressure wound therapy (NPWT) as an alternative to standard primary closure of open abdominal wounds following elective surgery with the goal of preventing surgical site infections (SSIs).

Technology Description: Negative pressure wound therapy (NPWT) is a therapeutic dressing system in which negative pressure is continuously or intermittently applied to the wound. The device consists of an occlusive dressing which is sealed over the wound and connected to drainage tubing connected to a suction pump that delivers negative pressure of from −50 to −125 mm Hg. The goal of prophylactic NPWT is to aid wound healing, generally in patients with factors putting them at higher risk of SSI, by the removal of exudate or debris, reduction of bacterial contamination, increase in local blood flow, and the production of granulation tissue.

Controversy: While NPWT is commonly used for the treatment for open wounds, postdebridement of acute or chronic wounds, and after reconstructive surgery, its role as a preventive measure to reduce SSI and other postoperative complications following elective open abdominal surgery is not well defined.

Key Questions:

  • Is prophylactic NPWT effective for reducing the rate of SSIs and other non-SSI outcome measures following elective open abdominal surgery?

  • How does prophylactic NPWT compare with standard sterile dressing (SSD) or other wound closure interventions following elective open abdominal surgery?

  • Is prophylactic NPWT safe following elective open abdominal surgery?

  • Have definitive patient selection criteria been identified for prophylactic NPWT in patients undergoing elective open abdominal surgery?

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