{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:46:14Z","timestamp":1791963974929,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients undergoing emergency laparotomy are at high risk of surgical site infections (SSI), which contribute substantially to postoperative morbidity. Incisional negative pressure wound therapy (iNPWT) has been shown to reduce the incidence of SSI following elective surgery, however, its effectiveness in the emergency setting remains uncertain. Therefore, we conducted a systematic review and meta\u2010analysis to evaluate the effectiveness of iNPWT in reducing SSI after emergency laparotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched PubMed, Embase, and Cochrane through November 2025 for randomized controlled trials (RCTs) and observational studies comparing iNPWT to standard dressings after emergency laparotomy. Odds ratios (OR) and mean differences (MD) were pooled for relevant outcomes with 95% confidence intervals using random\u2010effects and inverse variance weighting. A two\u2010tailed\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt; 0.05 was considered significant. Prespecified subgroup analyses restricted to RCTs were performed. Statistical heterogeneity was assessed using the I\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen studies (6 RCTs and 9 observational) including 3369 patients were analyzed. It was found that iNPWT was associated with significantly lower odds of overall (OR 0.36;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0003), superficial, and deep SSI, with consistent findings in RCT\u2010only analysis (OR 0.41;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0221). iNPWT was also associated with lower odds of seroma (OR 0.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0325), with consistent results observed in RCT\u2010only analyses (OR 0.54;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.025). Hospital length of stay was shorter in the iNPWT group (MD \u22121.49\u00a0days;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04), and iNPWT was associated with lower odds of wound dehiscence (OR 0.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0062), however, these findings were not confirmed in RCT\u2010only analyses. Postoperative complications, classified according to the Clavien\u2013Dindo system, did not differ between groups (OR 0.93;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.4973). Overall mortality was comparable between groups, although iNPWT was associated with higher follow\u2010up mortality. This finding was not confirmed in RCTs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients undergoing emergency laparotomy, iNPWT was associated with reduced odds of SSI and wound\u2010related complications compared with standard dressings. Although iNPWT was associated with higher follow\u2010up mortality, this finding was not confirmed in RCT\u2010only analyses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70526","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:52:27Z","timestamp":1786953147000},"page":"2848-2860","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Prophylactic Incisional Negative Pressure Wound Therapy on Surgical Site Infection After Emergency Laparotomy: An Updated Meta\u2010Analysis With Trial Sequential Analysis"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9126-0821","authenticated-orcid":false,"given":"Ana Lu\u00edza Rocha Soares","family":"Menegat","sequence":"first","affiliation":[{"name":"University of Caxias do Sul  Caxias do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5703-1687","authenticated-orcid":false,"given":"Brenda Luana Rocha Soares","family":"Menegat","sequence":"additional","affiliation":[{"name":"University of Caxias do Sul  Caxias do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6562-4823","authenticated-orcid":false,"given":"Sara","family":"Bravin","sequence":"additional","affiliation":[{"name":"Independent Researcher  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6476-0645","authenticated-orcid":false,"given":"Jacopo","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6357-8286","authenticated-orcid":false,"given":"Henrique","family":"Wiederkehr","sequence":"additional","affiliation":[{"name":"Faculdades Pequeno Pr\u00edncipe  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(10)61458\u20104"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.70069"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.004818"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2011.05.056"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.04.009"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.04.029"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845\u2010020\u201002283\u20107"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.07.063"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.12.006"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211054529"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.9087"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0014.9759"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2021.01.013"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15474"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010019\u201003398\u20109"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010023\u201006908\u20107"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2020.407"},{"key":"e_1_2_11_20_1","unstructured":"J. P. T.Higgins Cochrane Handbook for Systematic Reviews of Interventions Version 6.5 (2024)."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010016\u20100384\u20104"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u201025"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102015\u2010010247"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental\u20102019\u2010300117"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604.ch13"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1221"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4002"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2380"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.4097\/kja.21218"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010017\u20100315\u20107"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.17085\/apm.21038"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.24764"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.21614\/sgo\u2010684"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2025.100864"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.70718"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.53555\/q9hp8637"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010024\u201000560\u20109"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2023.10.055"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348251339700"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.08.009"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.23922\/jarc.2023\u2010059"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14350"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2019.309"},{"key":"e_1_2_11_48_1","volume-title":"Global Guidelines for the Prevention of Surgical Site Infection [Internet]","year":"2018"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/1553350611414920"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2003.12.1.26451"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12810"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70526","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70526","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70526","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:00:51Z","timestamp":1791961251000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":50,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/wjs.70526"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70526","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}