Prophylactic closed-incision negative pressure wound therapy for open ventral incisional hernia repair with mesh: a meta-analysis of randomized controlled trials.
6 affiliations
- 1Department of General Surgery, Kaifeng155 Hospital, China RongTong Medical Healthcare Group Co.Ltd., Kaifeng, China.
- 2Department of Gastroenterology, Huaihe Hospital, Henan University, Kaifeng, Henan, China.
- 3Department of Urology, Kaifeng155 Hospital, China RongTong Medical Healthcare Group Co.Ltd., Kaifeng, China.
- 4Kaifeng Minimally Invasive Diagnosis and Treatment Engineering Technology Research Center for Prostate Hyperplasia, Kaifeng, China.
- 5Henan Province Prostate Disease Precision Diagnosis and Treatment Engineering Research Center of Traditional Chinese and Western Medicine, Kaifeng, China.
- 6Discipline Construction Department, China RongTong Medical Healthcare Group Co.Ltd., Chengdu, China.
Abstract
Objective
To systematically evaluate the effects of prophylactic closed-incision negative pressure wound therapy (ciNPWT) on surgical site infection (SSI), seroma incidence and length of hospital stay after open ventral incisional hernia repair with mesh.Methods
Four databases (Cochrane Library, Embase, PubMed, Web of Science) were searched from inception to June 2026 for randomized controlled trials (RCTs) comparing prophylactic ciNPWT versus conventional sterile dressings in open ventral incisional hernia repair with mesh. The primary outcome was postoperative SSI incidence; secondary outcomes included seroma incidence and hospital stay. Study quality was assessed using the Cochrane Risk of Bias tool (RoB 1.0), and meta-analysis was performed with both fixed-effect and random-effects models using RevMan software. The certainty of evidence was assessed using the GRADE approach.Results
Four RCTs involving 420 patients (208 in ciNPWT group, 212 in control group) were included. Under the fixed-effect model, ciNPWT tended to reduce SSI risk without statistical significance (RR = 0.52, 95% CI 0.26-1.04, P = 0.06, I² = 50%). The random-effects model yielded a consistent but more conservative estimate (RR = 0.55, 95% CI 0.20-1.53, P = 0.25). No significant difference was found in seroma incidence (RR = 0.83, 95% CI 0.39-1.74, P = 0.61). ciNPWT was associated with shortened postoperative hospital stay (MD = -1.02 days, 95% CI -1.61 to -0.43, P = 0.0007), though this finding was based on only two studies and driven primarily by a single trial. Sensitivity analysis indicated that the SSI result was materially influenced by a single trial. Given the small number of included studies (k = 4), funnel plot asymmetry could not be reliably interpreted as evidence of publication bias. The GRADE certainty of evidence was rated as low for SSI and very low for seroma and hospital stay.Conclusion
Current evidence from randomized controlled trials suggests that prophylactic ciNPWT may be associated with shortened hospital stay after mesh-based ventral incisional hernia repair and shows a non-significant trend toward reducing SSI and seroma. However, the certainty of evidence is low to very low, the SSI result is materially dependent on a single trial, and the hospital stay finding is inconsistent across studies. Therefore, no definitive conclusion can be drawn regarding infection reduction, and the hospital stay benefit requires confirmation. More large-sample, multicenter, high-quality RCTs are needed for further validation.
Related
- Prophylactic antibiotics for pancreaticoduodenectomy: study protocol for a multicenter randomized controlled trial comparing tazobactam/piperacillin versus ampicillin/sulbactam.
- Prophylactic Low-Dose Esketamine for Prevention of Intraoperative Penile Erection During Ureteroscopic Surgery Under General Anesthesia: A Randomized, Double-Blind, Placebo-Controlled Trial.
- Combined Use of Adhesive Mesh Closure and Closed-Incision Negative Pressure Therapy for High-Risk Surgical Wounds: A Proof-Of-Concept Study.
- Tumour region identification guided scoring (TRIGS) and foundation model-based Tumour Infiltrating Lymphocyte scoring are prognostic for pathological complete response/event free survival in the triple negative patients in the PARTNER randomized controlled trial
- Effects of Stoic Training on Fear of Negative Evaluation and Responses to Social-Evaluative Stress: A Randomized Controlled Trial
BibTeX
@article{liu2026prophylactic,
title = {{Prophylactic closed-incision negative pressure wound therapy for open ventral incisional hernia repair with mesh: a meta-analysis of randomized controlled trials.}},
author = {Yihang Liu and Yuqing Lu and Song Li and Kaichun Li and Ming Li},
journal = {Frontiers in surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1962267},
url = {https://europepmc.org/article/MED/42948285},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prophylactic closed-incision negative pressure wound therapy for open ventral incisional hernia repair with mesh: a meta-analysis of randomized controlled trials.
AU - Yihang Liu
AU - Yuqing Lu
AU - Song Li
AU - Kaichun Li
AU - Ming Li
PY - 2026
DA - 2026/10/19
JO - Frontiers in surgery
DO - 10.3389/fsurg.2026.1962267
UR - https://europepmc.org/article/MED/42948285
AB - Objective To systematically evaluate the effects of prophylactic closed-incision negative pressure wound therapy (ciNPWT) on surgical site infection (SSI), seroma incidence and length of hospital stay after open ventral incisional hernia repair with mesh.Methods Four databases (Cochrane Library, Embase, PubMed, Web of Science) were searched from inception to June 2026 for randomized controlled trials (RCTs) comparing prophylactic ciNPWT versus conventional sterile dressings in open ventral incisional hernia repair with mesh. The primary outcome was postoperative SSI incidence; secondary outcomes included seroma incidence and hospital stay. Study quality was assessed using the Cochrane Risk of Bias tool (RoB 1.0), and meta-analysis was performed with both fixed-effect and random-effects models using RevMan software. The certainty of evidence was assessed using the GRADE approach.Results Four RCTs involving 420 patients (208 in ciNPWT group, 212 in control group) were included. Under the fixed-effect model, ciNPWT tended to reduce SSI risk without statistical significance (RR = 0.52, 95% CI 0.26-1.04, P = 0.06, I² = 50%). The random-effects model yielded a consistent but more conservative estimate (RR = 0.55, 95% CI 0.20-1.53, P = 0.25). No significant difference was found in seroma incidence (RR = 0.83, 95% CI 0.39-1.74, P = 0.61). ciNPWT was associated with shortened postoperative hospital stay (MD = -1.02 days, 95% CI -1.61 to -0.43, P = 0.0007), though this finding was based on only two studies and driven primarily by a single trial. Sensitivity analysis indicated that the SSI result was materially influenced by a single trial. Given the small number of included studies (k = 4), funnel plot asymmetry could not be reliably interpreted as evidence of publication bias. The GRADE certainty of evidence was rated as low for SSI and very low for seroma and hospital stay.Conclusion Current evidence from randomized controlled trials suggests that prophylactic ciNPWT may be associated with shortened hospital stay after mesh-based ventral incisional hernia repair and shows a non-significant trend toward reducing SSI and seroma. However, the certainty of evidence is low to very low, the SSI result is materially dependent on a single trial, and the hospital stay finding is inconsistent across studies. Therefore, no definitive conclusion can be drawn regarding infection reduction, and the hospital stay benefit requires confirmation. More large-sample, multicenter, high-quality RCTs are needed for further validation.
SN - 2296-875X
ER -