Background: Surgical site infections (SSIs) remain a serious problem following abdominal surgery due to gynecologic malignancies leading to increased hospitalization, high costs, and delays in adjuvant treatments; thus, SSIs affect overall survival. The aim of the present meta-analysis was to investigate the impact of closed incision–negative pressure wound treatment (ci-NPWT) systems on postoperative surgical site occurrences (SSOs) after gynecologic oncology surgery.Methods: The present meta-analysis was designed using the PRISMA guidelines. A search in several databases was conducted from inception until March 2025.Results: Overall, five studies were included; these studies enrolled 1174 patients in total, where 412 were treated with ci-NPWT systems and 762 were treated with conventional gauze. Patients treated with ci-NPWT systems presented with lower SSI rates (OR 0.40, 95% CI 0.15–1.10,p= 0.08), lower fascial dehiscence rates (OR 0.72, 95% CI 0.21–2.42,p= 0.59), and lower seroma formation rates (OR 0.70, 95% CI 0.25–1.93,p= 0.49), although statistical significance was not reached in all comparisons. On the other hand, patients treated with ci-NPWT systems also presented with higher postoperative hematoma formation rates (OR 1.38, 95% CI 0.32–5.99,p= 0.66), although statistical significance was not reached. Preoperative patient characteristics, operative parameters, and cancer characteristics were similar among the two study groups.Conclusions: The prophylactic use of ci-NPWT systems showed promising results in reducing postoperative SSOs after gynecologic cancer surgery. Nevertheless, prospectively designed studies are needed in the future to reach robust evidence that would enable the wide implementation of such devices in routine clinical practice.
背景：妇科恶性肿瘤腹部手术后，手术部位感染（SSIs）仍是严重问题，可导致住院时间延长、治疗成本增加及辅助治疗延迟，从而影响患者总体生存率。本荟萃分析旨在探讨闭合切口负压伤口治疗（ci-NPWT）系统对妇科肿瘤术后手术部位并发症（SSOs）的影响。 方法：本研究依据PRISMA指南设计荟萃分析方案，检索多个数据库自建库至2025年3月的相关文献。 结果：共纳入5项研究，累计1174例患者，其中412例接受ci-NPWT系统治疗，762例采用传统纱布敷料。ci-NPWT治疗组患者表现出更低的SSI发生率（OR 0.40，95% CI 0.15–1.10，p=0.08）、更低的筋膜裂开率（OR 0.72，95% CI 0.21–2.42，p=0.59）及更低的血清肿形成率（OR 0.70，95% CI 0.25–1.93，p=0.49），但各项比较均未达到统计学显著性。另一方面，ci-NPWT治疗组术后血肿形成率较高（OR 1.38，95% CI 0.32–5.99，p=0.66），但同样未达统计学显著性。两组患者在术前特征、手术参数及肿瘤特征方面具有可比性。 结论：预防性使用ci-NPWT系统在降低妇科肿瘤术后SSOs方面展现出良好前景。然而，未来仍需开展前瞻性研究以获得确凿证据，推动该技术在临床实践中的广泛应用。
肿瘤(癌症)患者之家