Prophylactic closed-incision negative pressure wound therapy after median sternotomy: a scoping review of surgical site infection prevention bundle reporting and implication for interpretation.

内容摘要

Closed-incision negative pressure wound therapy (ciNPT) is increasingly used to reduce surgical site infection (SSI) after median sternotomy, yet its true preventive effect remains uncertain. Published studies rarely specify which infection prevention measures were used alongside the therapy, making interpretation difficult. In this scoping review, we examined the completeness of reporting of infection prevention practices in studies evaluating ciNPT after cardiac surgery. A systematic search of PubMed, Scopus, and the Cochrane Library identified studies of adult cardiac surgery in which negative pressure therapy was applied prophylactically to the closed sternal incision. Information on study design, patient characteristics, therapy protocols, clinical outcomes, and reporting of infection prevention elements was extracted. Reporting was classified as complete, partial, or absent according to 13 components derived from major clinical guidelines. Twenty-five studies met the inclusion criteria. Most studies reported fewer SSIs in patients receiving negative pressure therapy, but none described a complete set of infection prevention measures. Eighty-seven percent of recommended elements were not reported, and selective use of the therapy introduced additional bias. The substantial absence of infection prevention reporting limits the interpretability and reproducibility of current evidence. Standardized and transparent documentation is required to better define the preventive value of ciNPT.