{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:42:19Z","timestamp":1791981739554,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,23]],"date-time":"2022-01-23T00:00:00Z","timestamp":1642896000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Closed\u2010incision negative pressure wound therapy (ciNPT) has shown promising effects for managing infected wounds. This meta\u2010analysis explores the current state of knowledge on ciNPT in orthopedics and addresses whether ciNPT at \u2212125\u2009mmHg or \u221280\u2009mmHg or conventional dressing reduces the incidence of surgical site complications in hip and knee arthroplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This meta\u2010analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta\u2010analysis (PRISMA) guidelines and Cochrane Handbook. Prospective randomized controlled trials (RCTs) with ciNPT use compared to conventional dressings following hip and knee surgeries were considered for inclusion. Non\u2010stratified and stratified meta\u2010analyses of six RCTs were conducted to test for confounding and biases. A <jats:italic>P<\/jats:italic> value less than .05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The included six RCTs have 611 patients. Total hip and knee arthroplasties were performed for 51.7% and 48.2% of the included population, respectively. Of 611 patients, conventional dressings were applied in 315 patients and 296 patients received ciNPT. Two ciNPT systems have been used across the six RCTs; PREVENA Incision Management System (\u2212125\u2009mmHg) (63.1%) and PICO dressing (\u221280\u2009mmHg) (36.8%). The non\u2010stratified analysis showed that the ciNPT system had a statistically significant, lower risk of persistent wound drainage as compared to conventional dressing following total hip and knee arthroplasties (OR\u00a0=\u00a00.28; <jats:italic>P<\/jats:italic>\u00a0=\u2009.002). There was no difference between ciNPT and conventional dressings in terms of wound hematoma, blistering, seroma, and dehiscence. The stratified meta\u2010analysis indicated that patients undergoing treatment with high\u2010pressure ciNPT (120\u2009mmHg) displayed significantly fewer overall complications and persistent wound drainage (<jats:italic>P<\/jats:italic>\u00a0=\u2009.00001 and <jats:italic>P<\/jats:italic>\u00a0=\u2009.002, respectively) when compared to low\u2010pressure ciNPT (80\u2009mmHg) and conventional dressings. In addition, ciNPT is associated with shorter hospital stays. (<jats:italic>P<\/jats:italic>\u00a0=\u2009.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When compared to conventional wound dressing and \u221280\u2009mmHg ciNPT, the use of \u2212125\u2009mmHg ciNPT is recommended in patients undergoing total joint arthroplasty.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.425","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T07:23:52Z","timestamp":1643009032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>Closed\u2010incision<\/scp> negative pressure therapy at \u2212125\u00a0<scp>mmHg<\/scp> significantly reduces surgical site complications following total hip and knee arthroplasties: A stratified meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2637-9341","authenticated-orcid":false,"given":"Kareem G.","family":"Elhage","sequence":"first","affiliation":[{"name":"FAJR Scientific  Northville Michigan 48167 USA"},{"name":"Wayne State University, School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed E.","family":"Awad","sequence":"additional","affiliation":[{"name":"FAJR Scientific  Northville Michigan 48167 USA"},{"name":"NorthStar Anesthesia\u2010Detroit Medical center  Detroit Michigan USA"},{"name":"Michigan State University, College of Osteopathic Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furqan B.","family":"Irfan","sequence":"additional","affiliation":[{"name":"Michigan State University, College of Osteopathic Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Lumbley","sequence":"additional","affiliation":[{"name":"NorthStar Anesthesia\u2010Detroit Medical center  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamal","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Wayne State University, School of Medicine  Detroit Michigan USA"},{"name":"Surgical Outcomes Research Institute, John D. Dingell VA Medical Center  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7734-1933","authenticated-orcid":false,"given":"Khaled J.","family":"Saleh","sequence":"additional","affiliation":[{"name":"FAJR Scientific  Northville Michigan 48167 USA"},{"name":"Michigan State University, College of Osteopathic Medicine  Detroit Michigan USA"},{"name":"Surgical Outcomes Research Institute, John D. Dingell VA Medical Center  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2010.03.017"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.10.035"},{"key":"e_1_2_12_4_1","unstructured":"CJRR.Hip and Knee Replacements in Canada. 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