{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:53:56Z","timestamp":1791010436315,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Incisional negative pressure wound therapy has expanded from a niche adjunct to a widely adopted strategy for the prevention and management of wound complications in selected surgical settings. However, available systems differ in pressure profile, fluid handling, dressing interface, and suitability for fragile skin or anatomically challenging incisions, while practical guidance for device selection remains limited. Whether iNPWT should be used selectively is an established question; which system characteristics are relevant once its use has been judged appropriate is not. We conducted a structured narrative review of the literature on incisional negative pressure wound therapy published between January 2013 and September 2026, based on a targeted PubMed\/MEDLINE search. Clinical studies addressing primarily closed surgical incisions were reviewed across elective, emergency, and reconstructive settings; conventional negative pressure wound therapy for open wounds was considered only in order to define the boundary between the two indications. Device technical characteristics were extracted separately from manufacturers' instructions for use and clinician guidelines. Evidence was synthesised in relation to clinical indication, incision and patient characteristics, device features, reported outcomes, and treatment\u2010related adverse events. On this basis, a clinical\u2010requirement\u2010first decision framework for bedside device selection was developed, with each component labelled as direct clinical evidence, indirect clinical evidence, documented technical characteristic, or expert clinical consideration. The available evidence supports a selective rather than routine use of incisional negative pressure wound therapy. The greatest clinical value appears in high\u2010risk incisions and in settings where oedema, superficial fluid accumulation, or limited soft\u2010tissue protection are likely to contribute to wound morbidity. Reported benefits vary according to procedure type, baseline risk, endpoint definition, and device configuration. Published studies evaluate complete proprietary systems rather than isolated technical variables. The only randomised comparison between two commercial systems identified was small and found no difference between them. Adverse events remain relevant and may limit treatment in fragile skin or when drainage exceeds the fluid\u2010handling capacity declared for the selected dressing. Incisional negative pressure wound therapy should be considered an adjunct to standard preventive measures, not a universal solution. A structured approach integrating anticipated fluid\u2010handling requirements, perilesional skin tolerance, seal feasibility over the relevant anatomy, and intended therapy duration may support more rational and transparent device selection once iNPWT has been judged appropriate. Current evidence does not establish a hierarchy among commercially available incisional systems, and the framework should be regarded as structured decision support rather than as a validated algorithm.<\/jats:p>","DOI":"10.1111\/iwj.71074","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:27:08Z","timestamp":1791008828000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current Incisional Negative Pressure Wound Therapy Systems: Technical Characteristics and a Decision Framework for Device Selection"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6501-2725","authenticated-orcid":false,"given":"Luca","family":"Folini","sequence":"first","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6118-4278","authenticated-orcid":false,"given":"Alfio Luca","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Ligresti","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Maria Pia Hospital Institute  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Zona","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7683-3508","authenticated-orcid":false,"given":"Daniele","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6638-9010","authenticated-orcid":false,"given":"Vincenzo","family":"Vindigni","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Bassetto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0820-541X","authenticated-orcid":false,"given":"Carlotta","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1055\/s-0041-1731792","article-title":"Negative Pressure Wound Therapy: Mechanism of Action and Clinical Applications","volume":"35","author":"Normandin S.","year":"2021","journal-title":"Seminars in Plastic Surgery"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/iwj.12170","article-title":"Negative Pressure Wound Therapy: Past, Present and Future","volume":"10","author":"Orgill D. P.","year":"2013","journal-title":"International Wound Journal"},{"issue":"5","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.jcot.2019.06.015","article-title":"Vacuum Assisted Closure or Negative Pressure Wound Therapy for Difficult Wounds: A Review","volume":"10","author":"Agarwal P.","year":"2019","journal-title":"Journal of Clinical Orthopaedics and Trauma"},{"issue":"3","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/0022034509359125","article-title":"Factors Affecting Wound Healing","volume":"89","author":"Guo S.","year":"2010","journal-title":"Journal of Dental Research"},{"key":"e_1_2_12_6_1","volume-title":"StatPearls","author":"Wallace H. A.","year":"2025"},{"issue":"2","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/iwj.12612","article-title":"Closed Incision Negative Pressure Therapy: International Multidisciplinary Consensus Recommendations","volume":"14","author":"Willy C.","year":"2017","journal-title":"International Wound Journal"},{"issue":"36","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"e4673","DOI":"10.1097\/MD.0000000000004673","article-title":"A Systematic Review and Meta\u2010Analysis Including GRADE Qualification of the Risk of Surgical Site Infections After Prophylactic Negative Pressure Wound Therapy Compared With Conventional Dressings in Clean and Contaminated Surgery","volume":"95","author":"De Vries F. E. E.","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/SLA.0000000000003644","article-title":"Meta\u2010Analysis, Meta\u2010Regression, and GRADE Assessment of Randomized and Nonrandomized Studies of Incisional Negative Pressure Wound Therapy Versus Control Dressings for the Prevention of Postoperative Wound Complications","volume":"272","author":"Zwanenburg P. R.","year":"2020","journal-title":"Annals of Surgery"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"102105","DOI":"10.1016\/j.eclinm.2023.102105","article-title":"Incisional Negative Pressure Wound Therapy for the Prevention of Surgical Site Infection: An Up\u2010To\u2010Date Meta\u2010Analysis and Trial Sequential Analysis","volume":"62","author":"Groenen H.","year":"2023","journal-title":"EClinicalMedicine"},{"issue":"12","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"e83743","DOI":"10.1371\/journal.pone.0083743","article-title":"A Systematic Review of Risk Factors Associated With Surgical Site Infections Among Surgical Patients","volume":"8","author":"Korol E.","year":"2013","journal-title":"PLoS One"},{"key":"e_1_2_12_12_1","unstructured":"Smith & Nephew \u201cPICO 7 Single Use Negative Pressure Wound Therapy System: User Manual and 510(k) Summary K203716 \u201dUS Food and Drug Administration https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf20\/K203716.pdf."},{"key":"e_1_2_12_13_1","unstructured":"3M\/Solventum \u201cPrevena Incision Management System With Prevena Peel & Place Dressing: Instructions for Use for Clinicians and Product Technical Information \u201dhttps:\/\/www.solventum.com\/en\u2010us\/home\/f\/b5005265118\/."},{"key":"e_1_2_12_14_1","unstructured":"3M\/Solventum \u201cSnap Therapy System: Clinician Guidelines \u201dhttps:\/\/www.solventum.com\/content\/dam\/public\/language\u2010masters\/en\/msb\/document\/2020\/SNAP\u2010Therapy\u2010System\u2010Clinician\u2010Guidelines\u2010US\u201070\u20102011\u20108227\u20109.pdf."},{"key":"e_1_2_12_15_1","unstructured":"M\u00f6lnlycke Health Care \u201cAvance Solo Negative Pressure Wound Therapy System: Product and Clinical Documentation \u201dhttps:\/\/www.molnlycke.com\/contentassets\/d6a67c4ba6f94a9687b8295d2e31308b\/avance\u2010solo\u2010\u2010adapt\u2010\u2010\u2010brochure.pdf."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13744"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d62b25"},{"issue":"5","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/1471-0528.15413","article-title":"Prophylactic Incisional Negative Pressure Wound Therapy Reduces the Risk of Surgical Site Infection After Caesarean Section in Obese Women: A Pragmatic Randomised Clinical Trial","volume":"126","author":"Hyldig N.","year":"2019","journal-title":"BJOG : An International Journal of Obstetrics and Gynaecology"},{"key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"n893","DOI":"10.1136\/bmj.n893","article-title":"Closed Incision Negative Pressure Wound Therapy Versus Standard Dressings in Obese Women Undergoing Caesarean Section: Multicentre Parallel Group Randomised Controlled Trial","volume":"373","author":"Gillespie B. M.","year":"2021","journal-title":"BMJ"},{"issue":"6","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1016\/j.jvs.2018.05.224","article-title":"A Randomized Clinical Trial Evaluating Negative Pressure Therapy to Decrease Vascular Groin Incision Complications","volume":"68","author":"Kwon J.","year":"2018","journal-title":"Journal of Vascular Surgery"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2026.04.017"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.21614\/sgo\u2010684"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2024.0339"},{"issue":"5","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"e2141","DOI":"10.1097\/GOX.0000000000002141","article-title":"A Comparative Trial of Incisional Negative\u2010Pressure Wound Therapy in Abdominoplasty","volume":"7","author":"Abesamis G. M.","year":"2019","journal-title":"Plastic and Reconstructive Surgery. Global Open"},{"issue":"4","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1007\/s00266-020-02122-1","article-title":"The Role of Portable Incisional Negative Pressure Wound Therapy in Reducing Local Complications of Postbariatric Brachioplasty: A Case\u2010Control Study","volume":"45","author":"Facchin F.","year":"2021","journal-title":"Aesthetic Plastic Surgery"},{"issue":"1","key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/BOT.0b013e318216b1e5","article-title":"Incisional Negative Pressure Wound Therapy After High Risk Lower Extremity Fractures","volume":"26","author":"Stannard J. P.","year":"2012","journal-title":"Journal of Orthopaedic Trauma"},{"issue":"6","key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1001\/jama.2020.0059","article-title":"Effect of Incisional Negative Pressure Wound Therapy vs Standard Wound Dressing on Deep Surgical Site Infection After Surgery for Lower Limb Fractures Associated With Major Trauma: The WHIST Randomized Clinical Trial","volume":"323","author":"Costa M. L.","year":"2020","journal-title":"Journal of the American Medical Association"},{"issue":"4","key":"e_1_2_12_28_1","first-page":"519","article-title":"The Impact of Incisional Negative Pressure Wound Therapy on Scar Quality and Patient Reported Outcomes: A Within Patient\u2010Controlled, Randomised Trial","volume":"30","author":"Timmermans F. W.","year":"2022","journal-title":"Wound Repair and Regeneration"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0b013e3182995516"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2026.3516"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrag027"},{"issue":"6","key":"e_1_2_12_32_1","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1016\/j.jvs.2021.12.070","article-title":"Meta\u2010Analysis of Prophylactic Closed Incision Negative Pressure Wound Therapy for Vascular Surgery Groin Wounds","volume":"75","author":"Boll G.","year":"2022","journal-title":"Journal of Vascular Surgery"},{"key":"e_1_2_12_33_1","first-page":"CD011354","article-title":"Negative Pressure Wound Therapy for Treating Leg Ulcers","volume":"7","author":"Dumville J. C.","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"5","key":"e_1_2_12_34_1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/wrr.12727","article-title":"A Prospective, Randomized, Controlled Clinical Trial on the Efficacy of a Single Use Negative Pressure Wound Therapy System, Compared to Traditional Negative Pressure Wound Therapy in the Treatment of Chronic Ulcers of the Lower Extremities","volume":"27","author":"Kirsner R.","year":"2019","journal-title":"Wound Repair and Regeneration"},{"issue":"1","key":"e_1_2_12_35_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/wrr.12858","article-title":"A Systematic Review Evaluating the Influence of Incisional Negative Pressure Wound Therapy on Scarring","volume":"29","author":"Zwanenburg P. R.","year":"2021","journal-title":"Wound Repair and Regeneration"},{"issue":"5","key":"e_1_2_12_36_1","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/1471-0528.15573","article-title":"Cost\u2010Effectiveness of Incisional Negative Pressure Wound Therapy Compared With Standard Care After Caesarean Section in Obese Women: A Trial Based Economic Evaluation","volume":"126","author":"Hyldig N.","year":"2019","journal-title":"BJOG : An International Journal of Obstetrics and Gynaecology"},{"issue":"5","key":"e_1_2_12_37_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/ajo.13677","article-title":"Cost\u2010Effectiveness of Closed Incision Negative Pressure Wound Therapy in Preventing Surgical Site Infection Among Obese Women Giving Birth by Caesarean Section: An Economic Evaluation","volume":"63","author":"Whitty J. A.","year":"2023","journal-title":"Australian and New Zealand Journal of Obstetrics and Gynaecology"},{"issue":"6","key":"e_1_2_12_38_1","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1007\/s00268-023-06908-7","article-title":"Does Prophylactic Negative\u2010Pressure Wound Therapy Prevent Surgical Site Infection After Laparotomy? A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials","volume":"47","author":"Meyer J.","year":"2023","journal-title":"World Journal of Surgery"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.71074","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.71074","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.71074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:27:13Z","timestamp":1791008833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.71074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":37,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/iwj.71074"],"URL":"https:\/\/doi.org\/10.1111\/iwj.71074","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71074"}}