Abstract
Background Surgical site infection (SSI) after pancreaticoduodenectomy is associated with significant
morbidity, increased hospital stays, delay in adjuvant treatment, and overburden on
hospital resources. There is no consensus in the management of these wounds.
Methods We performed a systematic review. We searched the PubMed, Embase, and Scopus on March
23, 2022 for studies reporting on negative pressure wound therapy (NPWT) in patients
operated on with pancreaticoduodenectomy. We included all studies that reported the
comparative outcomes of NPWT in patients undergoing pancreaticoduodenectomy. All data
were extracted by two reviewers separately. The pooled odds risk of SSI was calculated
using the metabin command and Mantel–Haenszel approach.
We assessed the risk of bias using Joanna Briggs Institute's critical appraisal tool
for cohort studies.
Results Four studies with 878 participants were included. The pooled odds ratio for SSI was
lower in the NPWT group as compared with standard care (0.36; 95% confidence interval
[CI]: 0.24–0.54; I
2 = 0). The pooled odds ratio of organ space infection was 0.40 (95% CI: 0.24–0.67;
I
2 = 0) on the basis of three studies (484 participants). We did not perform any subgroup
analyses because of lack of heterogeneity in the reported results and limited number
of studies.
Conclusion Pancreaticoduodenectomy is associated with high risk of SSI. The use of prophylactic
NPWT after pancreaticoduodenectomy is associated with decreased risk of SSI. The cost–benefit
ratio of NPWT over standard care requires further comparative study.
Keywords
wound infection - SSI - negative pressure wound therapy - pancreaticoduodenectomy
- surgery
