Prophylactic negative pressure wound therapy reduces surgical site infection in gastrointestinal, hepatobiliary, and pancreatic laparotomy

BACKGROUND: Surgical site infections (SSIs) remain a major complication following gastrointestinal, hepatobiliary-pancreatic, and pancreatic surgery. This systematic review and meta-analysis aimed to assess the efficacy of prophylactic negative pressure wound therapy (NPWT) in reducing SSIs following closed abdominal incisions. METHODS: A systematic search was conducted in PubMed, Embase, the Web of Science, and the Cochrane Library for studies published from January 2016 to December 2025; all databases were last searched on December 31, 2025, without language restrictions. Both randomized and nonrandomized studies were included. The primary outcome was SSI, while wound dehiscence (WD) was considered a secondary outcome. The risk of bias was assessed using the Cochrane Risk of Bias Tool 2.0 (Cochrane, London, UK). Meta-analyses were performed using Stata/MP version 18.0 (StataCorp LLC, College Station) with a random-effects model and Hartung-Knapp-Sidik-Jonkman correction. A Sankey diagram was generated using Origin 2022 (OriginLab Corporation, Northampton). RESULTS: A total of 10 studies (6 randomized trials and 4 retrospective studies) involving 3301 patients were included. Among them, 900 patients received NPWT, and 2401 patients received standard dressings. A random-effects model with Hartung-Knapp-Sidik-Jonkman correction meta-analysis indicated that NPWT significantly reduced the overall incidence of SSI compared with standard dressings (odds ratio [OR] = 0.63; 95% confidence interval [CI] = 0.41-0.99; P = .04). NPWT also significantly decreased the rates of superficial SSI (OR = 0.51; 95% CI = 0.37-0.69; P < .01) and deep SSI (OR = 0.45; 95% CI = 0.23-0.87; P = .03). However, no significant differences were observed for organ-space SSI or WD. CONCLUSION: Prophylactic NPWT reduces the risk of SSI among patients undergoing gastrointestinal, hepatobiliary-pancreatic, and pancreatic abdominal surgeries. Nevertheless, the rates of organ-space SSI and WD are comparable to those associated with standard dressings.