Objectives. The period of post-operative treatment before surgical wounds
are completely closed remains a key window, during which one can
apply new technologies that can minimise complications. One such
technology is the use of negative pressure wound therapy to manage
and accelerate healing of the closed incisional wound (incisional
NPWT). . Methods. We undertook a literature review of this emerging indication
to identify evidence within orthopaedic surgery and other surgical
disciplines. Literature that supports our current understanding
of the mechanisms of action was also reviewed in detail. . Results. A total of 33 publications were identified, including nine clinical
study reports from orthopaedic surgery; four from cardiothoracic
surgery and 12 from studies in abdominal, plastic and vascular disciplines.
Most papers (26 of 33) had been published within the past three
years. Thus far two randomised controlled trials – one in orthopaedic
and one in cardiothoracic surgery – show evidence of reduced incidence
of wound healing complications after between three and five days
of post-operative NPWT of two- and four-fold, respectively. Investigations
show that reduction in haematoma and seroma, accelerated wound healing
and increased clearance of oedema are significant mechanisms of
action. . Conclusions. There is a rapidly emerging literature on the effect of NPWT
on the closed incision. Initiated and confirmed first with a randomised
controlled trial in orthopaedic trauma surgery, studies in abdominal,
plastic and vascular surgery with high rates of complications have
been reported recently. The evidence from
