Combined Use of Adhesive Mesh Closure and Closed‐Incision Negative Pressure Therapy for High‐Risk Surgical Wounds: A Proof‐Of‐Concept Study

Surgical wound complications remain a major challenge, particularly in high-risk patients. Closed-incision negative pressure wound therapy (ciNPWT) and adhesive mesh closure systems have shown benefits independently, but their combined use has not been previously evaluated. This single-centre prospective proof-of-concept study included consecutive patients at extremely high risk of wound complications undergoing complex surgical procedures. All patients were treated with adhesive mesh closure (Dermabond Prineo) and ciNPWT (PICO) using a standardized protocol. Outcomes were compared with a historical cohort treated with conventional skin closure. Primary outcomes were wound healing and surgical site complications; secondary outcomes included persistent drainage, delayed healing, readmissions and duration of therapy. Seventeen surgical procedures (16 patients) were included in the prospective cohort and 39 in the historical cohort. The combined strategy achieved consistent wound healing without device-related or allergic complications. Compared with controls, no significant difference was observed for the composite outcome of surgical site complications (17.6% vs. 23.1%), although lower rates were observed for persistent drainage (0 vs. 23.1%, p = 0.045), delayed healing (5.9% vs. 20.5%) and readmissions (0 vs. 20.5%); only persistent drainage reached statistical significance. ciNPWT duration was shorter (12.3 vs. 17.3 days; p = 0.006). This combined approach appears feasible and safe in a highly selected cohort of high-risk patients, with preliminary findings suggesting potential reductions in wound-related complications.