The role of negative incisional pressure in the prevention of surgical site complications in patients with median incisional hernia.

Abstract

<h4>Background</h4>A single-center retrospective study was conducted to investigate whether the prophylactic application of a single-use negative pressure wound therapy (sNPWT) dressing on closed surgical incisions following incisional hernia (IH) repair of the abdominal wall with meshes reduces the risk of surgical site occurrence (SSO) and the necessity for surgical reoperation.<h4>Methods</h4>A retrospective study was conducted on 55 patients with incisional hernias classified as W2 (> 4-10 cm) or W3 (> 10 cm) according to the European Hernia Society classification, treated between 2013 and 2023. All patients underwent open surgical repair with mesh and were assigned to either a conventional flat dressing group (n = 34) or an sNPWT group using PICO 7 (n = 21). Weekly follow-ups were performed, and outcomes were statistically analyzed to compare the incidence of SSOs and reoperations between the two groups.<h4>Results</h4>At 30 days postoperatively, the control group showed a higher incidence of SSOs (32.35%, 11 cases) compared to the PICO 7 group (19.05%, 4 cases, P = 0.28). The need for surgical reintervention was also higher in the control group (17.65%, 6 cases) versus the PICO 7 group (10.53%, 2 cases, P = 0.41). Regardless of dressing type, elevated BMI (P = 0.02), advanced age, and diabetes were identified as key risk factors for SSOs.<h4>Conclusions</h4>sNPWT with PICO 7 may reduce SSOs and reoperations in open incisional hernia repair, particularly in high-risk patients with elevated BMI. Although statistical significance was not achieved, sNPWT appears to be a valuable adjunct in postoperative management. Further research is necessary to confirm its efficacy and determine the ideal patient population.