Incisional Negative Pressure Wound Therapy Research Articles

Negative-Pressure Wound Therapy for Prevention of Sternal Wound Infection after Adult Cardiac Surgery: Systematic Review and Meta-Analysis.

The results of current studies are not conclusive on the efficacy of incisional negative-pressure wound therapy (NPWT) for the prevention of sternal wound infection (SWI) after adult cardiac surgery. A systematic review of the literature was performed through PubMed, Scopus and Google to identify studies which investigated the efficacy of NPWT to prevent SWI after adult cardiac surgery. Available data were pooled using RevMan and Meta-analyst with random effect models. Out of 191 studies retrieved from the literature, ten fulfilled the inclusion criteria and were included in this analysis. The quality of these studies was judged fair for three of them and poor for seven studies. Only one study was powered to address the efficacy of NPWT for the prevention of postoperative SWI. Pooled analysis of these studies showed that NPWT was associated with lower risk of any SWI (4.5% vs. 9.0%, RR 0.54, 95% CI 0.34–0.84, I2 48%), superficial SWI (3.8% vs. 4.4%, RR 0.63, 95% CI 0.29–1.36, I2 65%), and deep SWI (1.8% vs. 4.7%, RR 0.46, 95% CI 0.26–0.74, I2 0%), but such a difference was not statistically significant for superficial SWI. When only randomized and alternating allocated studies were included, NPWT was associated with a significantly lower risk of any SWI (3.3% vs. 16.5%, RR 0.22, 95% CI 0.08–0.62, I2 0%), superficial SWI (2.6% vs. 12.4%, RR 0.21, 95% CI 0.06–0.69, I2 0%), and deep SWI (1.2% vs. 4.8%, RR 0.17, 95% CI 0.03–0.95, I2 0%). This pooled analysis showed that NPWT may prevent postoperative SWI after adult cardiac surgery. NPWT is expected to be particularly useful in patients at risk for surgical site infection and may significantly reduce the burden of resources needed to treat such a complication. However, the methodology of the available studies was judged as poor for most of them. Further studies are needed to obtain conclusive results on the potential benefits of this preventative strategy.

Surgical site infection requiring hospitalisation unchanged with a prophylactic incisional negative pressure wound therapy guideline: an observational cohort study

Background: Despite numerous published prospective studies, evidence to support use of prophylactic incisional negative pressure wound therapy, for obstetric and gynaecologic surgery, is conflicting.
 Aim: To evaluate if wound-related presentations to hospital were reduced following introduction of a guideline promoting selective use of prophylactic incisional negative pressure wound therapy.
 Methods: This was an observational cohort study. Electronic medical records were reviewed for all hospital presentations, within 30 days of primary surgery performed by laparotomy, where the responsible clinician was an obstetrician or gynaecologist. Rates of wound complications and costs associated with admission were compared pre- and post-guideline.
 Results: Among all those who underwent caesarean birth (n = 2788) or gynaecologic laparotomy (n= 263), 5% presented to hospital with SSI, and 1% with non-infected wound problems. No significant reductions in SSI hospital presentations, length of stay, or readmission costs were observed post-implementation. Likewise, no improvements were observed for non-infected wound problems or a composite of SSI and non-infected wound problems.
 Conclusions: This study does not support the selective approach used to direct prophylactic incisional negative pressure wound therapy. Further studies are required to better individualise risk assessment, and to determine if negative pressure wound therapy can reduce serious morbidity of SSI. When robust evidence is lacking, local outcomes should be evaluated systematically and reviewed before new treatments become standard care.

Closed Incision Negative Pressure Wound Therapy Versus Standard Dressings in Obese Women Undergoing Cesarean Section: Multicenter Parallel Group Randomized Controlled Trial

(BMJ. 2021;373:n893) Cesarean deliveries (CD) lead to increased risk for adverse maternal outcomes, especially for obese women. Obesity during pregnancy is common and increases the risk of postoperative complications such as surgical site infection (SSI), hematoma and seroma, and wound dehiscence. Use of closed incision negative pressure wound therapy (NPWT) dressings has increased in an effort to decrease SSI. This trial aimed to analyze how closed incision NPWT dressings compare with standard dressings in obese women following CD.

Incisional Negative Pressure Wound Therapy Is Protective Against Postoperative Cardiothoracic Wound Infection.

Sternal wound infections are a rare but life-threatening complication of cardiothoracic surgery. Prior literature has supported the use of negative pressure wound therapy to decrease sternal wound infections and promote healing. This study sought to determine whether closed incision negative pressure therapy reduced wound infection and improved outcomes in cardiothoracic surgery. A retrospective cohort study was performed including all adult patients who underwent nontraumatic cardiothoracic surgery at a single institution between 2016 and 2018 (n = 1199). Patient characteristics, clinical variables, and surgical outcomes were compared between those who did and did not receive incisional negative pressure wound therapy intraoperatively. Multivariable logistic regression analysis determined factors predictive or protective of the development of complications. Incisional negative pressure wound therapy was used in 58.9% of patients. Patients who received this therapy were older with statistically higher rates of hyperlipidemia, statin, and antihypertensive use. The use of negative pressure wound therapy was found to significantly reduce rates of both wound infection (3.0% vs 6.3%, P = 0.01) and readmission for wound infection (0.7% vs 2.6%, P = 0.01). After controlling for confounding variables, negative pressure wound therapy was found to be a protective factor of surgical wound infection (odds ratio, 0.497; 95% confidence interval, 0.262-0.945). In the largest population studied to date, this study supported the expanded use of negative pressure therapy on sternal wound incisions to decrease infection rates.

Negative pressure wound therapy in patients with diabetes undergoing left internal thoracic artery harvest: A randomized control trial

BackgroundPatients with diabetes undergoing CABG are at risk of wound infection. Incisional negative pressure wound therapy has been shown to be effective in decreasing incidence of infection in high-risk wounds. Near infrared spectroscopy (NIRS) can be used to assess wound oxygenation and low values can predict infection. ObjectivesTo evaluate utility of NIRS to assess wound oxygenation, to assess effect of sternotomy, left internal thoracic artery harvest, and wound dressing type on wound edge oxygenation. MethodsIn this blinded randomized control trial, patients with diabetes undergoing isolated coronary artery bypass grafting with a left internal thoracic artery were randomized to receive either incisional negative pressure wound therapy dressing or a standard dressing. NIRS measurements were made on the left upper arm (control), and left and right parasternal regions on day –1 (preoperative), day 5, and week 6 after surgery. Results were analyzed using repeated measures parametric methods. ResultsEighty patients with diabetes were recruited, 40 to the incisional negative pressure wound therapy group and 40 to the standard dressing group. Adjusted NIRS readings dropped significantly in all patients by day 5 and partially recovered by week 6. In both groups, there was no difference between readings on the left and right. At all time points and on both sides, there was no difference in readings between patients in the 2 groups. ConclusionsNIRS can be used to assess oxygenation adjacent to a sternotomy wound. Adjusted tissue oxygen levels change with time after sternotomy and left internal thoracic artery harvest in patients with diabetes. Wound dressing type does not influence day 5 wound edge oxygenation.

Incisional Negative Pressure Wound Therapy to Decrease the Incidence of Surgical Site Infections in Trauma Laparotomy Wounds.

Surgical site infection (SSI) is a common post-operative complication, especially in trauma laparotomies. Incisional negative pressure wound therapy (iNPWT) is a novel technique in reducing SSIs. We aim to study the rate of wound complications in trauma laparotomy with standard primary closure with staples vs iNPWT. We had 152 patients meeting inclusion criteria who underwent emergent trauma laparotomies performed at Sentara Norfolk General from 2017 to 2020. We had 79 patients in the standard staple group and 73 patients in the iNWPT group. We then analyzed surgical site infection rates and wound complication rates in both groups within a 30-day period. The wound infection rate in the staple vs staple plus iNPWT was 10.0% vs 3.8%, respectively (P = .13). Wound dehiscence rates were 24.1% vs 10.13%, respectively (P = .02). When looking at a subset of patients with hollow viscous injury, the rate of SSIs was statistically lower in the iNPWT group. Prior to the introduction of the incisional vacuum-assisted closure (VAC) to our practice compared to after its introduction, 39.25% of wounds were left open vs 19.51%, respectively (P = .001). Our data identified a trend toward a decrease in overall SSIs in trauma laparotomies closed with iNPWT. The use of iNPWT demonstrated a decrease in superficial wound dehiscence and a decrease in SSIs in patients with associated full thickness bowel injury. With iNPWT, we are more aggressive with primarily closing trauma laparotomy wounds. This shows promise for increasing primary closure rates while simultaneously decreasing overall superficial surgical site infection rate.

P146. INCISIONAL NEGATIVE PRESSURE WOUND THERAPY IS PROTECTIVE OF POSTOPERATIVE CARDIOTHORACIC WOUND INFECTION

PURPOSE: Sternal wound infections are a rare but life-threatening complication of cardiothoracic surgery. Prior literature has supported the use of negative pressure wound therapy to decrease sternal wound infections and promote healing. This study sought to determine whether closed incision negative pressure therapy (ciNPT) reduced wound infection and improved outcomes in cardiothoracic surgery. METHODS: A retrospective cohort study was performed including all adult patients who underwent nontraumatic cardiothoracic surgery at a single institution between 2016 and 2018 (n=1199). Patient characteristics, clinical variables, and surgical outcomes were compared between those who did and did not receive incisional negative pressure wound therapy intraoperatively. Multivariable regression analysis determined factors predictive or protective of the development of complications. RESULTS: Incisional negative pressure wound therapy was used in 58.9% of patients. Patients who received this therapy were older with statistically higher rates of hyperlipidemia, statin, and antihypertensive use. The use of negative pressure wound therapy was found to significantly reduce rates of both wound infection (3.0% vs 6.3%, p = 0.01) and readmission for wound infection (0.7% vs 2.6%, p = 0.01). After controlling for confounding variables, negative pressure wound therapy was found to be a protective factor of surgical wound infection (OR 0.497, 95% confidence interval 0.262 - 0.945). CONCLUSION: In the largest population studied to date, this study supported the expanded use of negative pressure therapy on sternal wound incisions to decrease infection rates.

Prophylactic Incisional Negative Pressure Wound Therapy Versus Standard Dressing After Major Lower Extremity Amputation: A Randomized Controlled Trial

We studied the efficacy of incisional negative pressure wound therapy (iNPWT) compared with traditional surgical gauze dressings after major lower extremity amputation in reducing wound-related complications and the time to prosthesis placement for patients with peripheral arterial disease (PAD).

Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy.

Background:Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether ciNPWT is effective at preventing complications in VHR-PAN. The aim of our study was to evaluate if ciNPWT improves outcomes of VHR-PAN.Methods:A retrospective review of patients who underwent VHR-PAN between 2009 and 2021 was conducted. Patients were divided into two groups: (1) those who received standard sterile dressings (SSD), or (2) ciNPWT. Primary outcomes were postoperative complications, including surgical site occurrences (SSO) and hernia recurrence.Results:A total of 114 patients were identified: 57 patients each in the SSD group and ciNPWT group. The groups were similar in demographics and comorbidities. There were more smokers in the SSD group (22.8% versus 5.3%, P = 0.013). Hernia defect size was significantly larger in patients who received ciNPWT (202.0 versus 143.4 cm2, P = 0.010). Overall SSO was similar between the two groups (23.2% versus 26.3%, P = 0.663). At a mean follow-up of 6.6 months, hernia recurrence rate was significantly higher in the SSD group compared with that in the ciNPWT group. (10.5% versus 0%, P = 0.027). Smoking, diabetes, component separation, mesh type, and location were not significantly associated with hernia recurrence.Conclusions:Application of incisional NPWT is beneficial in decreasing hernia recurrence in VHR-PAN, compared with standard dressings. Larger prospective studies are warranted to further elucidate the utility of ciNPWT in abdominal wall reconstruction.

423 Effectiveness of prophylactic negative pressure wound therapy after caesarean section in reducing superficial surgical site infection – a case-control study

Introduction and aims of the study: The increasing number of caesarean sections worldwide1 makes impaired healing of wounds after the procedure a frequent problem. Assessed risk of surgical site infections (SSI) is about 2-15% and 90% of them are superficial SSI. 2 Closed incision Negative Pressure Wound Therapy (NPWT) is a method under evaluation mainly in obese women undergoing caesarean deliveries with discrepant results. From the ones stating that NWPT vacuum dressings are efficient3 to the ones claiming that prophylactic usage in obese women did not reduce the incidence of SSIs. 4 The aim of the study was to evaluate wound healing outcomes in high-risk patients after caesarean section treated with and without the use of NPWT. Methods: In 2019 we prepared a list of identifiable risk factors of inappropriate wound healing. When a patient history confirmed at least 3 risk factors, we used prophylactic NPWT for 5 days (V.A.C. dressing). Patients data were retrospectively analysed. Group 1 were patients with NPWT from 2020 to march of 2021. A control group was created from patients data from the same time frame (hospital database), matching the intervention group for age, BMI and risk factors of SSIs. Outcomes assessed were the presence of wound complications, need for antibiotic therapy, readmission to hospital, length of stay and additional surgical procedures. Results: Patients in both the intervention group (n=21) and control group (n=6323) were included to the study. There was only one inappropriate wound healing in the intervention group. Moreover, usage of VAC was connected with shorter hospital stay, with no readmission to hospital and fewer antibiotic therapies and additional surgical procedures in comparison to control group. Conclusion: Closed incision NWPT is effective way of SSIs prophylaxis when proper qualification to intervention. More studies are needed, especially prospective ones, with the bigger study sample.

The impact of incisional negative pressure wound therapy on scar quality and patient-reported outcomes: A within-patient-controlled, randomised trial.

Literature provides a moderate level of evidence for the beneficial effects of incisional negative pressure wound therapy (iNPWT) on scar quality. The purpose of this study was to establish if iNPWT results in improved scar outcomes in comparison to the standard of care. Therefore, a within‐patient randomised controlled, open‐label trial was conducted in transgender men undergoing gender‐affirming mastectomies. A unilateral side was randomised to receive iNPWT (PICO™, Smith&Nephew) without suction drains and contrastingly the standard dressing (Steri‐Strips™) with suction drain. Scar quality and questionnaires were bilaterally measured by means of objective assessments and patient‐reported outcome measures (PROM) at 1, 3 and 12 months. Objective scar outcomes were scar pliability (Cutometer®), colouration (DSM‐II) and scar width (3‐D imaging). PROM outcomes were related to scars (POSAS and SCAR‐Q) and body satisfaction (BODY‐Q). From 85 included patients, 80 were included for analyses. No significant difference between treatments was seen in the quantitative outcomes of scar pliability, colour, and width. For qualitative scar outcomes, several significant findings for iNPWT were found for several subscales of the POSAS, SCAR‐Q, and BODY‐Q. These effects could not be substantiated with linear mixed‐model regression, signifying no statically more favourable outcome for either treatment option. In conclusion, this study demonstrated that some PROM outcomes were more favourable for the iNPWT compared to standard treatment. In contrast, the quantitative outcomes showed no beneficial effects of iNPWT on scar outcomes. This suggests that iNPWT is of little benefit as a scar‐improving therapy.

A0018 - Incisional negative pressure wound therapy for surgical site complications prevention in radical cystectomy

A0018 - Incisional negative pressure wound therapy for surgical site complications prevention in radical cystectomy

Effect of Incisional Negative Pressure Wound Therapy Following Incisional Hernia RepairA Randomised Controlled Trial

Introduction: Incisional hernia is one of the common complications following abdominal surgery in patients undergoing laparotomy. Various surgical procedures are performed by creating a potential space and placing a foreign body (mesh), which may render the wound susceptible for many postoperative complications. It is clinically important to evaluate the efficacy of Incisional Negative Pressure Wound Therapy (INPWT) in reducing wound complications. Aim: To compare the efficacy of INPWT dressing with traditional gauze dressing in reducing postoperative complications following meshplasty in incisional hernia repair. Materials and Methods: This was a hospital-based randomised controlled trial, conducted in the Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, from October 2013 to July 2015. 64 consenting patients with incisional hernias undergoing meshplasty were included in this study. After being randomised into the two study groups, they had their postoperative wounds dressed with either INPWT (Group A) for five days, or traditional gauze (Group B) based dressings. Operative parameters like duration of surgery, type of dissection and type of skin sutures used were studied and analysed. Also, postoperative outcomes like Surgical Site Infection (SSI), seroma, duration of drain, hospital stay were analysed using Chi-square or Fisher’s-exact test. Results: Out of total 64 patients, there was a statistically significant reduction in the volume of drain (p=0.004) and duration of wound drainage (p=0.029) with the use of INPWT. There was also a reduction in the incidence of SSI (6.7% vs 17.6%) and seroma (6.7% vs 11.8%) and the duration of postoperative hospital stay (6.03±1.99 days vs 7.09±2.31 days) in the INPWT group, which were however not statistically significant. Age, comorbidities, Body Mass Index (BMI), duration of surgery, type of dissection and type of skin sutures were not found to have any effect on the parameters assessed. Conclusion: Incisional negative pressure wound therapy in postoperative wounds, following meshplasty for incisional hernia significantly reduces the volume and duration of wound drainage. It also reduces the incidence of SSI, seroma and the duration of hospital stay

Patients' Experiences Using Closed Incision Negative Pressure Wound Therapy Dressing After Infra-Inguinal Vascular Surgery.

The PICO™ dressing utilizes incisional negative pressure wound therapy in reducing surgical site infection after vascular surgery; however, no patient-reported investigations are available. The objective was to explore patientś experiences wearing the PICO™ dressing for 7 days. Nine men and 6 women were interviewed, and analysis was conducted using qualitative content analysis. The PICO™ dressing system was well accepted by most patients. Most prominent problems were fear of dropping the pump to the floor, lack of information, and initial feelings of uncertainty. Four patients who had the PICO™ and standard dressing in opposite groins simultaneously, preferred the PICO™ dressing.

The Role of Incisional Negative Pressure Wound Therapy in Improving the Outcome of Reduction Mammoplasty, An Egyptian Experience

The Role of Incisional Negative Pressure Wound Therapy in Improving the Outcome of Reduction Mammoplasty, An Egyptian Experience

Closed Incision Negative Pressure Wound Therapy Following Pancreaticoduodenectomy for Prevention of Surgical Site Infections in High-risk Patients

Introduction: Surgical site infection (SSI) remains one of the most common causes of morbidity after pancreaticoduodenectomy. SSI is associated with fascial dehiscence, readmissions, prolonged length of stay, delayed adjuvant chemotherapy initiation, and negative effects on quality of life. Negative pressure wound therapy devices, also known as incisional vacuum-associated closure devices (iVAC), applied to closed incisions may reduce SSI rates; however, evidence for their use after pancreaticoduodenectomy is limited and has mixed results.

Negative pressure wound therapy for massive subcutaneous emphysema: a systematic review and case series.

BackgroundMassive subcutaneous emphysema can cause considerable morbidity with respiratory distress. To resolve this emphysema in short-term, negative pressure wound therapy could be applied as added treatment modality. However, its use is sparsely reported, and a variety of techniques are being described. This study provides a systematic review of the available literature on the effectiveness of negative pressure wound therapy as treatment for massive subcutaneous emphysema. In addition, our institutional experience is reported through a case-series.MethodsThe PubMed, Embase and Cochrane Library were systematically searched for publications on the use of negative pressure wound therapy for subcutaneous emphysema following thoracic surgery, trauma or spontaneous pneumothorax. Moreover, patients treated at our institution between 2019 and 2021 were retrospectively identified and analyzed.ResultsThe systematic review provided 10 articles presenting 23 cases. Studies demonstrated considerable heterogeneity regarding the location of incision, creation of prepectoral pocket, and surgical safety margin. Also closed incision negative pressure wound therapy and PICO© device were discussed. Despite the apparent heterogeneity, all techniques provided favorable outcomes. No complications, reinterventions or recurrences were documented. Furthermore, retrospective data of 11 patients treated at our clinic demonstrated an immediate response to negative pressure wound therapy and a full remission of the subcutaneous emphysema at the end of negative pressure wound therapy. No recurrence requiring intervention or complications were observed.ConclusionsThe findings of this study suggest that negative pressure wound therapy, despite the varying techniques employed, is associated with an immediate regression of subcutaneous emphysema and full remission at the end of therapy. Given the relatively low sample size, no technique of choice could be identified. However, in general, negative pressure wound therapy appears to provide fast regression of subcutaneous emphysema and release of symptoms in all cases.

Negative Pressure Wound Therapy in Facilitating Wound Healing After Surgical Decompression for Metastatic Spine Disease

The risk of wound-related complications, including surgical site infections (SSIs), in patients undergoing surgery for metastatic spine disease (MSD) is high. Consequently, patients requiring wound revision surgery face delay in resuming oncological care and incur additional hospitalization. Recent reports suggest that negative pressure wound therapy (NPWT) applied on a closed wound at the time of surgery significantly reduces postoperative wound complications in degenerative spine disease and trauma setting. Here, we report a single institution experience with incisional NPWT in patients undergoing surgery for MSD. We compared rates of wound complications requiring surgical revision in a surgical cohort of patients with or without NPWT from 2015 to 2020. Adult patients with radiographic evidence of MSD with mechanical instability and/or accelerated neurological decline were included in the study. NPWT was applied on a closed wound in the operating room and continued for 5 days or until discharge, whichever occurred first. A total of 42 patients were included: 28 with NPWT and 14 without. Patient demographics including underlying comorbidities were largely similar. NPWT patients had higher rates of prior radiation to the surgical site (36% vs. 0%, P= 0.017) and longer fusion constructs (6.7 vs. 3.9 levels, P < 0.001). Three patients (21%) from the control group and none from the NPWT group contracted SSI requiring wound washout (P= 0.032). Our data suggest that SSI and wound dehiscence are significantly reduced with the addition of incisional NPWT in this vulnerable population.

Perioperative management of acetabular and pelvic fractures: evidence-based recommendations.

The American Academy of Orthopaedic Surgeons does not currently provide clinical practice guidelines for management of PAF. Accordingly, this article aims to review and consolidate the relevant historical and recent literature in important topics pertaining to perioperative management of PAF. A thorough literature review using PubMed, Cochrane and Embase databases was performed to assess preoperative, intraoperative and postoperative management of PAF fracture. Topics reviewed included: time from injury to definitive fixation, the role of inferior vena cava filters (IVCF), tranexamic acid (TXA) use, intraopoperative cell salvage, incisional negative pressure wound therapy (NPWT), intraoperative antibiotic powder use, heterotopic ossification prophylaxis, and pre- and postoperative venous thromboembolism (VTE) prophylaxis. A total of 126 articles pertaining to the preoperative, intraoperative and postoperative management of PAF were reviewed. Articles reviewed by topic include 13 articles pertaining to time to fixation, 23 on IVCF use, 14 on VTE prophylaxis, 20 on TXA use, 10 on cell salvage, 10 on iNPWT 14 on intraoperative antibiotic powder and 20 on HO prophylaxis. An additional eight articles were reviewed to describe background information. Five articles provided information for two or more treatment modalities and were therefore included in multiple categories when tabulating the number of articles reviewed per topic. The literature supports the use of radiation therapy for HO prophylaxis, early (< 5days from injury) surgical intervention and the routine use of intraoperative TXA. The literature does not support the routine use of iNPWT or IVCF. There is inadequate information to make a recommendation regarding the use of cell salvage and wound infiltration with antibiotic powder. While the routine use of chemical VTE prophylaxis is recommended, there is insufficient evidence to recommend the optimal agent and duration of therapy.

Closed incision negative pressure wound therapy versus conventional dressings following soft-tissue sarcoma excision: a prospective, randomized controlled trial.

AimsThe primary objective of this study was to compare the postoperative infection rate between negative pressure wound therapy (NPWT) and conventional dressings for closed incisions following soft-tissue sarcoma (STS) surgery. Secondary objectives were to compare rates of adverse wound events and functional scores.MethodsIn this prospective, single-centre, randomized controlled trial (RCT), patients were randomized to either NPWT or conventional sterile occlusive dressings. A total of 17 patients, with a mean age of 54 years (21 to 81), were successfully recruited and none were lost to follow-up. Wound reviews were undertaken to identify any surgical site infection (SSI) or adverse wound events within 30 days. The Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) score were recorded as patient-reported outcome measures (PROMs).ResultsThere were two out of seven patients in the control group (28.6%), and two out of ten patients in the intervention group (20%) who were diagnosed with a SSI (p > 0.999), while one additional adverse wound event was identified in the control group (p = 0.593). No significant differences in PROMs were identified between the groups at either 30 days (TESS, p = 0.987; MSTS, p = 0.951) or six-month (TESS, p = 0.400) follow-up. However, neoadjuvant radiotherapy was significantly associated with a SSI within 30 days of surgery, across all patients (p = 0.029). The mean preoperative modified Glasgow Prognostic Score (mGPS) was also significantly higher among patients who developed a postoperative adverse wound event (p = 0.028), including a SSI (p = 0.008), across both groups.ConclusionThis is the first RCT comparing NPWT with conventional dressings following musculoskeletal tumour surgery. Postoperative wound complications are common in this group of patients and we observed an overall SSI rate of 23.5%. We propose proceeding to a multicentre trial, which will help more clearly define the role of closed incision NPWT in STS surgery.Cite this article: Bone Jt Open 2021;2(12):1049–1056.