How to Prevent Surgical Site Infection of Laparotomy Incisions Using Negative Pressure Wound Therapy

Abstract Background Surgical site infection (SSI) after laparotomy remains a major source of morbidity and cost. Closed-incision negative pressure wound therapy (ciNPWT) has been proposed to prevent wound complications in high-risk patients, yet real-world evidence from abdominal surgery remains heterogeneous. We report our first experience with SSI prevention using ciNPWT in open abdominal surgery. Methods We conducted a retrospective clinical study of adult patients undergoing laparotomy who received ciNPWT (Prevena™; continuous − 125 mmHg) applied within 24 h post-closure and maintained for 6 days. The primary outcome was uncomplicated primary intention healing through suture removal (prevention “success”). Demographics, comorbidities (including diabetes, obesity, cardiovascular disease), inflammatory markers, and glycemia were collected. Logistic regression explored associations between failure and comorbidity burden. The ciNPWT group was compared with a control group of 20 patients who did not receive ciNPWT after laparotomy. Results Twenty patients received a single ciNPWT cycle; overall prevention success was 80%. Failure occurred in 20%. Sex and admission type were not significantly associated with outcome; median age was 69 years in successes versus 75.5 years in failures (p = 0.155). No individual comorbidity showed a significant association with failure after multiplicity adjustment. Each additional comorbidity showed a non-significant trend toward lower failure odds (OR 0.45, 95% CI 0.16–1.27; p = 0.13). Uncomplicated wound healing was achieved in 80% (16/20) of patients treated with ciNPWT compared with 45% (9/20) in the control group. (Fisher’s exact test, p = 0.048; OR = 4.89), indicating borderline statistical significance. Conclusions Standardized ciNPWT after laparotomy was feasible and associated with higher uncomplicated healing rates. Despite borderline statistical significance, the findings support the potential benefit of ciNPWT and justify further controlled studies.