• Mark J Lambrechts, Nicholas D D'Antonio, Tariq Z Issa, Hannah A Levy, Goutham R Yalla, Emily Berthiaume, Kerri-Anne Ciesielka, Christopher K Kepler, and Jose A Canseco.
• Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Electronic address: mark.lambrechts@rothmanortho.com.
• World Neurosurg. 2022 Dec 1; 168: 258267.e1258-267.e1.

ObjectiveTo determine if closed incision negative pressure wound therapy (ciNPWT) decreases surgical site infection (SSI) or wound dehiscence after spinal fusion.MethodsFollowing PRISMA guidelines, a systematic review and meta-analysis were conducted to identify studies using ciNPWT after spinal fusion. Funnel plots and quality scores of the articles were performed to determine if the articles were at risk of bias. Forest plots were conducted to identify the treatment effect of ciNPWT after spinal fusion.ResultsA total of 8 studies comprising 1061 patients who received ciNPWT or a standard postoperative dressing after spinal fusion were included. The rate of SSI (ciNPWT, 4.49% [95% confidence interval (CI), 2.48-8.00] vs. control, 11.32% [95% CI, 7.51-16.70]; P = 0.0103) was significantly lower for patients treated with ciNPWT. A fixed-effects model showed no significant difference between patients who received ciNWPT or a standard postoperative dressing with respect to requiring reoperations for wound debridement (odds ratio, 1.25; 95% CI, 0.64-2.41). In addition, wound dehiscence was not significantly different between the 2 groups, although it was nonsignificantly lower in ciNWPT-treated patients (ciNPWT, 4.59% [95% CI, 2.49-8.31] vs. control: 7.48% [95% CI, 4.38-12.47]; P = 0.23).ConclusionsciNPWT may reduce the rates of SSI after spinal fusion. The use of ciNWPT may also significantly reduce the burden associated with postoperative wound complications, but the meta-analysis was insufficiently powered to make this association. Additional studies may identify a subset of patients who benefit from ciNPWT for other wound-related complications.Copyright © 2022 Elsevier Inc. All rights reserved.

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