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Trauma Care
Volume 5
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10.3390/traumacare5020011
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Systematic Review

Incisional Negative Pressure Wound Therapy Use on Orthopaedic Lower Extremity Trauma: An Updated Systematic Global Review

by
Kennedy Nkachukwu
1,
Emily R. Arellano
1,
Amanda Alejo
1,
Anna Cmolik
1,
Jeffrey W. Toman
1,
Jalal S. Jwayyed
1,
Nicholas Ventigan
1,
Justin E. Iwuagwu
1 and
Andrew L. Alejo
1,2,*
1
College of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
2
Department of Orthopaedics, Stony Brook University Hospital, Stony Brook, NY 11794, USA
*
Author to whom correspondence should be addressed.
Trauma Care 2025, 5(2), 11; https://doi.org/10.3390/traumacare5020011
Submission received: 30 March 2025 / Revised: 4 May 2025 / Accepted: 19 May 2025 / Published: 25 May 2025
Versions Notes

Abstract

Background: Advancements in surgical wound management have led to improved healing and reduced complications. Incisional negative pressure wound therapy (iNPWT) is a technique that applies sub-atmospheric pressure to closed surgical wounds, enhancing blood flow, minimizing edema, and promoting tissue repair. Initially developed for chronic wounds, its use has expanded across multiple surgical specialties, including orthopaedic trauma surgery, to reduce complications such as dehiscence, infection, and prolonged healing. While traditional wound care relies on standard closure methods with simple dressings, iNPWT offers additional mechanical support and may lower the risk of deep surgical site infections (SSIs). This review examines the current evidence on iNPWT’s role in preventing SSIs following surgery for lower extremity fractures to guide clinical decision-making and improve patient outcomes. Methods: A systematic search through PubMed and MEDLINE utilizing our inclusion and exclusion criteria yielded seven randomized controlled trials and randomized prospective cohort studies that were subsequently analyzed to determine iNPWT effectiveness. Results: Of the seven studies, five showed a decreased SSI rate compared to standard wound dressing, with the other two exhibiting an increased infection rate. Conclusions: This review critically examines existing literature on iNPWT, analyzing level I and II studies on deep SSI rates in traumatic fractures. The evidence remains inconclusive on whether iNPWT offers a significant advantage over standard wound dressings, highlighting the need for further research to clarify its efficacy and clinical application.
Keywords: incisional negative pressure wound therapy; deep surgical site infection; lower extremity fractures; orthopaedic trauma; fractures incisional negative pressure wound therapy; deep surgical site infection; lower extremity fractures; orthopaedic trauma; fractures

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MDPI and ACS Style

Nkachukwu, K.; Arellano, E.R.; Alejo, A.; Cmolik, A.; Toman, J.W.; Jwayyed, J.S.; Ventigan, N.; Iwuagwu, J.E.; Alejo, A.L. Incisional Negative Pressure Wound Therapy Use on Orthopaedic Lower Extremity Trauma: An Updated Systematic Global Review. Trauma Care 2025, 5, 11. https://doi.org/10.3390/traumacare5020011

AMA Style

Nkachukwu K, Arellano ER, Alejo A, Cmolik A, Toman JW, Jwayyed JS, Ventigan N, Iwuagwu JE, Alejo AL. Incisional Negative Pressure Wound Therapy Use on Orthopaedic Lower Extremity Trauma: An Updated Systematic Global Review. Trauma Care. 2025; 5(2):11. https://doi.org/10.3390/traumacare5020011

Chicago/Turabian Style

Nkachukwu, Kennedy, Emily R. Arellano, Amanda Alejo, Anna Cmolik, Jeffrey W. Toman, Jalal S. Jwayyed, Nicholas Ventigan, Justin E. Iwuagwu, and Andrew L. Alejo. 2025. "Incisional Negative Pressure Wound Therapy Use on Orthopaedic Lower Extremity Trauma: An Updated Systematic Global Review" Trauma Care 5, no. 2: 11. https://doi.org/10.3390/traumacare5020011

APA Style

Nkachukwu, K., Arellano, E. R., Alejo, A., Cmolik, A., Toman, J. W., Jwayyed, J. S., Ventigan, N., Iwuagwu, J. E., & Alejo, A. L. (2025). Incisional Negative Pressure Wound Therapy Use on Orthopaedic Lower Extremity Trauma: An Updated Systematic Global Review. Trauma Care, 5(2), 11. https://doi.org/10.3390/traumacare5020011

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