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However, often, underlying patient comorbidities in addition to surgical\u2010related factors make the management of surgical wounds primary closure challenging because of the higher risk of developing complications. To date, extensive evidence exists, which demonstrate the benefits of negative pressure dressing in the treatment of open wounds; recently, Incisional Negative Pressure Wound Therapy (<jats:styled-content style=\"fixed-case\">INPWT<\/jats:styled-content>) technology as delivered by Prevena\u2122 (<jats:styled-content style=\"fixed-case\">KCI USA<\/jats:styled-content>, Inc., San Antonio, <jats:styled-content style=\"fixed-case\">TX<\/jats:styled-content>) and Pico (Smith &amp; Nephew Inc, Andover, <jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content>) systems has been the focus of a new investigation on possible prophylactic measures to prevent complications via application immediately after surgery in high\u2010risk, clean, closed surgical incisions. A systematic review was performed to evaluate <jats:styled-content style=\"fixed-case\">INPWT<\/jats:styled-content>'s effect on surgical sites healing by primary intention. The primary outcomes of interest are an understanding of <jats:styled-content style=\"fixed-case\">INPWT<\/jats:styled-content> functioning and mechanisms of action, extrapolated from animal and biomedical engineering studies and incidence of complications (infection, dehiscence, seroma, hematoma, skin and fat necrosis, skin and fascial dehiscence or blistering) and other variables influenced by applying <jats:styled-content style=\"fixed-case\">INPWT<\/jats:styled-content> (re\u2010operation and re\u2010hospitalization rates, time to dry wound, cost saving) extrapolated from human studies. A search was conducted for published articles in various databases including <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>, Google Scholar and Scopus Database from 2006 to March 2014. Supplemental searches were performed using reference lists and conference proceedings. Studies selection was based on predetermined inclusion and exclusion criteria and data extraction regarding study quality, model investigated, epidemiological and clinical characteristics and type of surgery, and the outcomes were applied to all the articles included. 1 biomedical engineering study, 2 animal studies, 15 human studies for a total of 6 randomized controlled trials, 5 prospective cohort studies, 7 retrospective analyses, were included. Human studies investigated the outcomes of 1042 incisions on 1003 patients. The literature shows a decrease in the incidence of infection, sero\u2010haematoma formation and on the re\u2010operation rates when using <jats:styled-content style=\"fixed-case\">INPWT<\/jats:styled-content>. Lower level of evidence was found on dehiscence, decreased in some studies, and was inconsistent to make a conclusion. Because of limited studies, it is difficult to make any assertions on the other variables, suggesting a requirement for further studies for proper recommendations on <jats:styled-content style=\"fixed-case\">INPWT<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/iwj.12492","type":"journal-article","created":{"date-parts":[[2015,10,1]],"date-time":"2015-10-01T07:11:15Z","timestamp":1443683475000},"page":"1260-1281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":216,"title":["Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of Incisional Negative Pressure Wound Therapy. 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