Incisional Negative Pressure Wound Therapy Dressing in Total Joint Arthroplasty: what is the evidence? A Meta-Analysis

Background The purpose of this study is to evaluate whether incisional negative pressure therapy dressing (iNPWT) has an advantage over conventional wound dressing (CWD) on wound healing for patients with total joint arthroplasty (TJA) Methods We searched the electronic databases including PubMed, The Cochrane Library, EMBASE via Ovid SP, Medline via Ovid SP, to screening published randomized controlled trials and high-quality cohort studies reported that incisional negative pressure therapy dressing applied in hip and knee arthroplasty. We analyzed the overall complications, major and minor complications, dressing changes, infection rate, and the rate of reoperation. The relevant data was analyzed by RevMan5.3. Results Six studies met our criteria, and included 1405 incisions in 971 participants with total joint arthroplasty which were randomized either to incisional negative pressure therapy dressing group (n=578) or to conventional wound dressing group (n=827) .The risk for developing a minor complication between two groups was not significantly different (risk ratio [RR] 0.58, p =0.40) and for major complication was also not significantly different (RR 0.71, p =0.39). In terms of dressing changes, the iNPWT was fewer than the control group ( P <0.05). The effect of rate of infection and reoperation was not significantly different (RR 0.65, p =0.27). Conclusions For patients underwent TJA, applying iNPWT may be associated with fewer dressing change, which maybe mean less exudation. There was no significant difference on the rate of infection and reoperation, and experiencing either minor or major complications between participants in whom iNPWT versus CWD were used for wound. However, more high-quality randomized or non-randomized controlled trials with larger sample sizes and cost-effectiveness analysis are required.