Effect of negative pressure wound therapy on surgical wound outcomes in colorectal cancer surgery patients: a systematic review and meta-analysis

Abstract

Abstract Background Surgical site infections (SSI) and wound complications are major concerns in colorectal cancer (CRC) surgery. Negative pressure wound therapy (NPWT) has been proposed to reduce these complications, but its efficacy specifically in CRC surgery remains uncertain. This meta-analysis evaluates the impact of NPWT on surgical wound outcomes compared to standard wound care in patients undergoing CRC surgery. Methods A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library was conducted up to February 10, 2025, for studies comparing NPWT with standard wound care in CRC surgery patients. The primary outcome was total wound complications. Risk ratios (RR) and mean differences (MD) were pooled using a random-effects model, with heterogeneity assessed using I² statistics. Results Six studies involving 343 patients (NPWT: 171, control: 172) were included. NPWT did not significantly reduce total wound complications (RR: 0.67, 95% CI: 0.35–1.26, P = 0.21, I² = 66%). Similarly, no significant differences were found for SSI (RR: 0.80, 95% CI: 0.45–1.43, P = 0.45), even after sensitivity analysis resolved heterogeneity (RR: 0.62, 95% CI: 0.33–1.17, P = 0.14, I² = 0%). NPWT also showed no significant benefit in preventing wound dehiscence (RR: 2.44, P = 0.35), seroma (RR: 0.87, P = 0.92), or reducing reintervention rates (RR: 0.69, P = 0.36). The length of hospital stay was comparable between groups (MD: -0.25 days, P = 0.80). Conclusion This meta-analysis suggests that NPWT does not significantly reduce wound complications, SSI, or LOS in CRC surgery.