Efficacy of Negative Pressure Wound Therapy Compared to Conventional Wound Closure in Plastic and Reconstructive Surgery: A Systematic Review and Meta-Analysis

Background: Wound healing complications following plastic and reconstructive procedures remain a significant clinical challenge. Negative Pressure Wound Therapy (NPWT) has emerged as an alternative to conventional closure techniques (CCT), yet its comparative efficacy in plastic surgery populations remains incompletely synthesized. This systematic review and meta-analysis aimed to compare NPWT versus CCT for postoperative wound healing in plastic and reconstructive surgery. Methods: We systematically searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science from inception to January ۲۰۲۶ for randomized controlled trials (RCTs) and prospective cohort studies comparing NPWT with standard gauze, adhesive dressings, or primary closure in plastic surgery patients. Primary outcomes were complete wound healing rate, time to healing (days), and surgical site infection (SSI). Secondary outcomes included dehiscence, seroma, and hospital stay. Risk of bias assessed using Cochrane RoB ۲ and ROBINS-I tools. Random-effects meta-analyses performed. Results: Fourteen studies (n=۱,۲۴۷ patients) met inclusion criteria. NPWT significantly improved complete wound healing rate compared to CCT (risk ratio [RR]=۱.۱۸; ۹۵% CI: ۱.۰۹–۱.۲۸; p<۰.۰۰۱; I²=۴۲%). Time to healing was reduced by ۴.۸ days (۹۵% CI: -۶.۲ to -۳.۴; p<۰.۰۰۱; I²=۵۸%). SSI incidence was lower with NPWT (RR=۰.۵۴; ۹۵% CI: ۰.۳۹–۰.۷۵; p<۰.۰۰۱; I²=۰%). Dehiscence (RR=۰.۴۹; ۹۵% CI: ۰.۳۱–۰.۷۸) and seroma (RR=۰.۶۳; ۹۵% CI: ۰.۴۴–۰.۹۰) also favored NPWT. Hospital stay was reduced by ۲.۳ days (p=۰.۰۰۲). Conclusions: NPWT significantly enhances wound healing and reduces complications compared to conventional techniques in plastic and reconstructive surgery. These findings support NPWT as a preferred modality for high-risk surgical wounds and compromised tissue beds.

کلیدواژه ها:

negative pressure wound therapy ، plastic surgery ، wound healing ، Surgical Site Infection ، Reconstructive Surgical Procedures