What is the Impact of Negative Pressure Wound Therapy on Healing in Patients Post Excision of Pilonidal Sinus? A Systematic Review and Meta-Analysis.

This systematic review aimed to determine the impact of negative pressure wound therapy on healing in patients with pilonidal sinus following surgical excision. Using systematic review methodology, we included original research studies written in English. The search was conducted using CINAHL Plus, Ovid, PubMed, EBSCO Host and Cochrane databases. Quality appraisal was undertaken using the Cochrane Collaboration tool for assessing risk of bias and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Data were analysed using meta-analysis where appropriate; otherwise, the data are presented narratively. Ten studies were included with a mean sample size of 61 (SD: 33). Three studies were randomised control trials, four were retrospective studies, two were prospective cohort studies and one was pre-post study. Studies showed reduction in healing time, recurrence rates and postoperative pain, as well as higher patients' satisfaction with the use negative pressure wound therapy, however, the certainty of the evidence was very low. The evidence for the intervention is uncertain thus, it is unclear whether NPWT makes any difference when compared to any other dressings, on time to healing, recurrence, pain or patient's experience. Further high-quality research with larger sample sizes is recommended to clearly explore the impact of NPWT on PS healing, recurrence, pain and patient's satisfaction.