ArticleInternational wound journal2026
Protective Effect of Prophylactic Negative-Pressure Wound Therapy on Surgical-Site Infection in High-Risk Open Abdominal Surgery: A Retrospective Cohort Study and Nomogram Development.
Article in International wound journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Surgical-site infections (SSIs) are a major complication after open abdominal surgery, especially in high-risk patients (obesity, diabetes, immunosuppression). Prophylactic negative-pressure wound therapy (pNPWT) may reduce SSIs. This study evaluated pNPWT versus standard dressings and developed an SSI risk prediction nomogram. A single-centre retrospective study included 83 high-risk adults undergoing open abdominal surgery (2022-2024). Patients received pNPWT (n = 38, -125 mmHg for 5-7 days) or standard dressing (n = 45). Primary outcome: CDC-classified SSI within 30 days. Secondary outcomes included wound dehiscence, epithelialisation time, hospital stay, 30-day readmission and 3-month scar quality. Multivariate logistic regression identified SSI predictors; a nomogram was built and assessed (discrimination: AUC, calibration: bootstrap, utility: decision curve). SSI incidence was significantly lower with pNPWT (5.3% vs. 35.6%; p = 0.002). Compared with standard dressings, pNPWT shortened time to complete epithelialization (10.2 [8.90-11.4] vs. 14.5 [12.3-17.7] days; p < 0.001) and reduced postoperative length of stay (10.3 [8.88-12.2] vs. 13.4 [10.5-17.4] days; p < 0.001). In multivariable analysis, pNPWT was independently protective (adjusted OR: 0.030, 95% CI: 0.001-0.298; p = 0.011), while higher BMI (adjusted OR: 1.476; p = 0.013), higher HbA1c (adjusted OR: 3.726; p = 0.016) and longer incision length (adjusted OR: 1.441; p = 0.016) were associated with increased SSI risk. pNPWT significantly reduces SSIs and improves wound healing in high-risk open abdominal surgery. The developed nomogram accurately predicts individual SSI risk, aiding personalised prophylaxis. Prospective multi-centre RCTs with economic evaluations are needed to confirm findings and guide practice.
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