Negative pressure wound therapy cuts infections after emergency laparotomy, with a caveat

• Pooled analysis of 8 randomized trials (n = 1,348) found fewer surgical site infections with negative pressure wound therapy (RR 0.46; 95% CI 0.28 to 0.76).
• Heterogeneity was substantial, and the largest trial was neutral, so the infection signal is uncertain.
• Seroma and wound dehiscence were also lower, but hospital stay was not shorter.

Use it selectively, for high-risk emergency laparotomy wounds, not as routine closed-incision dressing until larger trials confirm the infection benefit.