Comparison of Negative Pressure Wound Therapy Systems and Conventional Non-Pressure Dressings on Surgical Site Infection Rate After Stoma Reversal: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Surgical site infections (SSIs) rank among the most common complications following stoma takedown and lead to increased morbidity, increased length of hospital stay (LOS), and higher healthcare costs. Negative Pressure Wound Therapy (NPWT) systems have emerged as a promising option for optimizing wound management and minimizing SSI rates. This systematic review and meta-analysis aims to compare postoperative outcomes of NPWT and conventional non-pressure dressings following stoma reversal. Methods: A literature search was conducted across MED-LINE/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus, as well as ClinicalTrials.gov, up to September 1, 2024. Only randomized controlled trials (RCTs) were in-cluded. The primary outcome was SSI rate, while secondary outcomes included time to complete wound healing, LOS, and patient-reported wound cosmesis. Results: Six RCTs, including 328 pa-tients, were ultimately eligible for inclusion. No significant difference was revealed in SSI rates between the NPWT and conventional dressing groups (OR = 0.95; 95% CI: 0.27–3.29; P = 0.94; I² = 38%). Time to complete wound healing was significantly lower in NPWT group, compared to conventional dressings (MD = -3.78 days; 95% CI: -6.29 to -1.27; P = 0.003). Two studies reported a lower rate of wound healing complications other than SSIs in the NPWT group (OR = 0.22; 95% CI: 0.05–1.09; P = 0.06). No substantial differences were observed in terms of LOS (MD = -0.02 days; 95% CI: -1.22 to 1.17; P = 0.97) and patient-reported wound cosmesis (SMD = 0.31; 95% CI: -0.49 to 1.11; P = 0.44). Conclusions: NPWT contributes to improved wound management through re-ducing wound healing time compared to non-pressure dressings after stoma reversal, although it does not appear to substantially impact SSI rates, LOS, or patient-assessed wound cosmesis. Further large-scale, multicenter RCTs are necessary to validate these results and identify patient populations most likely to benefit from NPWT application.