{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T16:56:17Z","timestamp":1764953777968,"version":"3.46.0"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Radical cystectomy (RC) is a complex urologic procedure that, when performed using an open surgical approach, carries a high risk of surgical site complications (SSCs), which can lead to prolonged recovery, increased healthcare costs, and higher morbidity. Incisional negative-pressure wound therapy (iNPWT) has demonstrated benefits in enhancing wound healing in various surgical settings, but its effectiveness in the context of RC remains underexplored. This study aimed to evaluate the impact of iNPWT on the incidence of SSCs following RC compared to standard surgical dressings using the PICO\u00ae system. Methods: A cohort of 146 patients who underwent RC between 2015 and 2021 was divided into two groups: those treated with standard dressings (Group 1, n = 80) and those who received iNPWT (Group 2, n = 66). Patient-related, surgical, and pathological variables were compared between the groups. Categorical variables were analyzed using the chi-square or Fisher\u2019s exact test, while continuous variables were assessed using Student\u2019s t-test. Univariate logistic regression models were applied to evaluate the association between iNPWT use and 90-day SSCs, as well as to identify risk factors for complications. Results: Group 2 (iNPWT) had a higher prevalence of chronic comorbidities, including chronic kidney disease, but fewer active smokers compared to Group 1. Higher body mass index, prolonged operative time, and uncontrolled diabetes were significantly associated with the development of SSCs. The incidence of SSCs within 90 days was significantly lower in the iNPWT group (7.6%) compared to the standard dressing group (22.5%) (p = 0.03). iNPWT use was associated with a substantially reduced risk of SSCs (OR: 0.282), demonstrating a protective effect. Conclusions: Prophylactic application of iNPWT following RC significantly reduced the incidence of surgical site complications compared to standard dressing. These findings support the potential of iNPWT as a valuable adjunct in perioperative wound management. While encouraging, these results warrant validation in prospective, randomized studies. Tailored postoperative strategies and identification of patient-specific risk factors remain essential components in SSC prevention and reflect the growing importance of precision medicine in surgical oncology.<\/jats:p>","DOI":"10.3390\/jpm15120581","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T16:37:02Z","timestamp":1764952622000},"page":"581","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incisional Negative-Pressure Wound Therapy Versus Standard Dressing for the Prevention of Surgical Site Complications Following Radical Cystectomy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3272-528X","authenticated-orcid":false,"given":"Fabio","family":"Traunero","sequence":"first","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"},{"name":"Department of Urology, Ospedale Santa Maria Della Misericordia di Udine, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Biasatti","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Rossin","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6678-669X","authenticated-orcid":false,"given":"Andrea","family":"Piasentin","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Zorzi","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Umari","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7234-3526","authenticated-orcid":false,"given":"Tommaso","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Urology, Santa Chiara Hospital, 38121 Trento, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2252-4297","authenticated-orcid":false,"given":"Alessandro","family":"Zucchi","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Pisa, 56122 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2431-5296","authenticated-orcid":false,"given":"Giovanni","family":"Liguori","sequence":"additional","affiliation":[{"name":"Urological Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"578","DOI":"10.3390\/curroncol29020052","article-title":"Clinical Outcomes and Prognosis Analysis of Younger Bladder Cancer Patients","volume":"29","author":"Abudurexiti","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.eururo.2023.08.016","article-title":"European Association of Urology Guidelines on Muscle-Invasive and Metastatic Bladder Cancer: Summary of the 2023 Guidelines","volume":"85","author":"Cathomas","year":"2024","journal-title":"Eur. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1016\/j.juro.2012.01.077","article-title":"The Implications of Hospital Acquired Adverse Events on Mortality, Length of Stay and Costs for Patients Undergoing Radical Cystectomy for Bladder Cancer","volume":"187","author":"Kim","year":"2012","journal-title":"J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10156-005-0391-1","article-title":"Incidence of and Risk Factors for Surgical Site Infection in Patients with Radical Cystectomy with Urinary Diversion","volume":"11","author":"Takeyama","year":"2005","journal-title":"J. Infect. Chemother."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.euf.2019.09.016","article-title":"Evaluation of Incisional Negative Pressure Wound Therapy in the Prevention of Surgical Site Occurrences After Radical Cystectomy: A New Addition to Enhanced Recovery After Surgery Protocol","volume":"6","author":"Joice","year":"2020","journal-title":"Eur. Urol. Focus."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1097\/SLA.0000000000002098","article-title":"Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations: A Randomized, Controlled, Open-Label Trial: The P.I.C.O. Trial","volume":"265","author":"Peirce","year":"2017","journal-title":"Ann. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1001\/jamasurg.2019.0431","article-title":"Negative Pressure Wound Therapy for Surgical Site Infection Prevention Requires Further Study Before Widespread Adoption-Reply","volume":"154","author":"Sahebally","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_8","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","year":"2017","journal-title":"Int. Wound J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/j.jamcollsurg.2016.12.028","article-title":"Phase II Randomized Trial of Negative-Pressure Wound Therapy to Decrease Surgical Site Infection in Patients Undergoing Laparotomy for Gastrointestinal, Pancreatic, and Peritoneal Surface Malignancies","volume":"224","author":"Shen","year":"2017","journal-title":"J. Am. Coll. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/01.JAA.0000531052.82007.42","article-title":"Update on Surgical Site Infections: The New CDC Guidelines","volume":"31","author":"Borchardt","year":"2018","journal-title":"Jaapa"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/j.eururo.2017.12.018","article-title":"Updates in the Eighth Edition of the Tumor-Node-Metastasis Staging Classification for Urologic Cancers","volume":"73","author":"Paner","year":"2018","journal-title":"Eur. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"253","DOI":"10.11124\/jbisrir-2015-1687","article-title":"Effectiveness of Negative Pressure Wound Therapy\/Closed Incision Management in the Prevention of Post-Surgical Wound Complications: A Systematic Review and Meta-Analysis","volume":"13","author":"Watts","year":"2015","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1111\/iwj.12492","article-title":"Improving Wound Healing and Preventing Surgical Site Complications of Closed Surgical Incisions: A Possible Role of Incisional Negative Pressure Wound Therapy. A Systematic Review of the Literature","volume":"13","author":"Scalise","year":"2016","journal-title":"Int. Wound J."},{"key":"ref_14","first-page":"e49","article-title":"Does the Application of Incisional Negative Pressure Therapy to High-Risk Wounds Prevent Surgical Site Complications? A Systematic Review","volume":"13","author":"Ingargiola","year":"2013","journal-title":"Eplasty"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.urology.2017.09.010","article-title":"Hospital Charges and Length of Stay Following Radical Cystectomy in the Enhanced Recovery After Surgery Era","volume":"111","author":"Semerjian","year":"2018","journal-title":"Urology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1016\/j.urolonc.2016.07.001","article-title":"Characterization of Perioperative Infection Risk among Patients Undergoing Radical Cystectomy: Results from the National Surgical Quality Improvement Program","volume":"34","author":"Parker","year":"2016","journal-title":"Urol. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/iju.15382","article-title":"Lower Bleeding Volume Contributes to Decreasing Surgical Site Infection in Radical Cystectomy: A Propensity Score-Matched Comparison of Open versus Robot-Assisted Radical Cystectomy","volume":"31","author":"Kamei","year":"2024","journal-title":"Int. J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1089\/end.2023.0279","article-title":"Perioperative and Complication Related Outcomes for Robotic-Assisted vs Open Radical Cystectomy: A Comparative National Surgical Quality Improvement Project Analysis","volume":"38","author":"Simhal","year":"2024","journal-title":"J. Endourol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1586\/17434440.3.2.175","article-title":"Subatmospheric Pressure Wound Therapy and the Vacuum-Assisted Closure Device: Basic Science and Current Clinical Successes","volume":"3","author":"Plikaitis","year":"2006","journal-title":"Expert. Rev. Med. Devices"},{"key":"ref_20","first-page":"210","article-title":"Surgical Site Infections in Patients Who Undergo Radical Cystectomy: Excess Mortality, Stay Prolongation and Hospital Cost Overruns","volume":"39","year":"2015","journal-title":"Actas Urol. Esp."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jhin.2009.03.020","article-title":"Surgical Site Infections: How High Are the Costs?","volume":"72","author":"Broex","year":"2009","journal-title":"J. Hosp. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.juro.2006.08.074","article-title":"Influence of Post-Cystectomy Complications on Cost and Subsequent Outcome","volume":"177","author":"Konety","year":"2007","journal-title":"J. Urol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000449472","article-title":"Deep Surgical Site Infections after Open Radical Cystectomy and Urinary Diversion Significantly Increase Hospitalisation Time and Total Treatment Costs","volume":"98","author":"Wolters","year":"2017","journal-title":"Urol. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"23779608241292839","DOI":"10.1177\/23779608241292839","article-title":"Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections: An Evidence-Based Literature Review","volume":"10","author":"Formosa","year":"2024","journal-title":"SAGE Open Nurs."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/581\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T16:52:05Z","timestamp":1764953525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,30]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jpm15120581"],"URL":"https:\/\/doi.org\/10.3390\/jpm15120581","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,30]]}}}