Effectiveness of negative pressure wound therapy in treating deep surgical site infections after spine surgery: a meta-analysis of single-arm studies.

Background: One of the common complications in spinal surgery patients is deep surgical site infections (SSIs). Deep SSIs refer to infections that involve the deeper soft tissues of the incision, such as the fascia and muscle layers. This complication can lead to prolonged hospitalization, repeated surgeries, and even life-threatening conditions. In recent years, Negative Pressure Wound Therapy (NPWT) has been widely used as an effective wound healing method in the management of post-surgical infections. However, there is a lack of systematic research and comprehensive reviews regarding the exact effectiveness of NPWT in the treatment of deep SSIs following spinal surgery. Therefore, we conducted this meta-analysis to explore the efficacy of NPWT in treating deep SSIs after spinal surgery, aiming to provide clearer evidence to support clinical practice.

Methods: A comprehensive search of databases, including CNKI, Wanfang data, VIP data, CBM, PubMed, Embase, Cochrane Library, and Web of Science, was conducted for studies up to August 20, 2024, examining the use of NPWT in treating SSIs after spinal surgery. Using Stata 15.0 software, we employed either fixed or random models to calculate combined effect sizes, depending on the level of heterogeneity observed.

Results: Of the 571 publications initially screened, 19 studies meeting the inclusion criteria were selected for analysis. The meta-analysis revealed that the mean duration of vacuum sealing drainage (VSD) treatment was 17.45 days [95% confidence interval (CI) (11.63 days, 23.28 days)], and the mean number of VSD uses was 2.57 times[95% CI (1.53times, 3.60times)]. Additionally, the recurrence rate of infection post-discharge was 2% (95% CI = 0-4%). The reoperation rate for internal fixation in NPWT-treated patients was 4% (95% CI = 0-14%).

Conclusion: Available evidence supports the effectiveness of NPWT in treating deep SSIs following spinal surgery, suggesting its clinical utility. However, further studies are needed to compare NPWT with other treatment options for SSIs management.

Registrations: PROSPERO CRD42024612412.