Work

Closed incision negative-pressure wound therapy in inguinal arterial surgery - an updated meta-analysis with additional subgroup analysis for overweight and diabetic populations

Year: 2026

Type: article

Study designs: Systematic Review, Meta-Analysis

Abstract: Objective Prior meta-analyses suggest that closed incision negative pressure wound therapy (CINPWT) decreases surgical site infections (SSIs), but its direct effect on high-risk populations like diabetic and overweight patients is not well-defined. Therefore, an updated meta-analysis to assess the impact of CINPWT on SSIs and, in addition, a subgroup analysis for diabetic and overweight populations was performed. Methods This systematic review and meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials comparing CINPWT with standard dressings in patients undergoing inguinal vascular operations. Outcomes included SSI, surgical site occurrence, readmission, wound revision, length of stay, and mortality. A random-effects model was used for analysis, with prespecified subgroup analyses for diabetic and overweight patients. Results Ten randomized controlled trials comprising 1449 patients with 1681 inguinal incisions were included. The risk of SSI was significantly decreased in the CINPWT group compared with the standard dressing group (10.8% vs 20.9%; relative risk [RR], 0.53; 95% confidence interval [CI], 0.40-0.71; P < .0001). In the diabetic subgroup, CINPWT significantly reduced SSI risk (15.4% vs 33.8%; RR, 0.47; 95% CI, 0.25-0.89; P = .02). Similarly, in the overweight subgroup (body mass index ≥25 kg/m 2 ), CINPWT significantly lowered SSI incidence (16.4% vs 38.0%; RR, 0.43; 95% CI, 0.27-0.69; P = .0005). Readmission, wound revision, and length of hospital stay were non-significantly reduced with CINPWT. Conclusions This meta-analysis highlights the prophylactic impact of negative pressure therapy in patients undergoing inguinal vascular operations. A significant reduction in SSIs was achieved in the negative pressure wound therapy group. This prophylactic effect is moderately higher in overweight patients compared with diabetic patients, making both groups potential candidates for this therapy.

Source: JVS-Vascular Insights

DOI: 10.1016/j.jvsvi.2026.100383