A new evidence review finds positive results when negative-pressure wound therapy is used on surgical incisions.


The comprehensive review of 33 published papers, which documents a reduced incidence of wound healing complications after NPWT for three to five days post-surgery, appears in a recent issue of Bone and Joint Research.


The BJR paper, jointly authored by a panel of six international experts on NPWT, examines research that investigates new technologies that can be applied to surgical incisions to help minimise complications. The panel conducted the review in orthopaedic and other surgical disciplines.


“According to a consensus of the randomised studies, there is a strong argument for the preventive use of NPWT on high-risk, closed incisions,” says co-author James Stannard, MD, professor and orthopaedic surgeon at the Missouri Orthopaedic Institute at the University of Missouri, who was the first surgeon to report the use of NPWT in this way. “Most surgeons are familiar with the efficacy of the use of NPWT on complex open wounds as that has become a standard of care. However, there is a growing awareness of the potential of incisional NPWT to reduce post-surgical complications in high-risk patients and the related costs involved. We expect that the development of lower cost, single-use NPWT devices will catalyse further studies.”


Three of the review’s co-authors – Matthias Brem, MD, MHBA, orthopaedic surgeon at Klinikum Nürnberg; Sudheer Karlakki, MBBS, FRCS(Ed), FRCS(Orth), consultant orthopaedic surgeon at the Robert Jones Agnes Hunt Orthopaedc Hospital; and Sandro Giannini, MD, head of the second clinic of orthopaedic and traumatologic surgery at Rizzoli Orthopedic Institute – are currently recruiting an independent investigator to initiate randomised studies with Smith & Nephew’s PICO™ single-use NPWT system.


“Single-use NPWT devices such as Smith & Nephew’s PICO™ mean that the lower cost of therapy can lead to many more opportunities to build clinical evidence in large randomised studies,” said co-author Robin Martin, BSc, MD, director of clinical Sciences at Smith & Nephew. “In a future article, we plan to assess the evidence for identifying those patients at greatest risk of surgical site complications (SSC) in orthopaedic procedures and review the guidelines to target certain patient groups with NPWT as a preventive technology. We also plan to examine the economic implications for such an approach as well.”