160 patients scheduled for a total joint arthroplasty (hip/knee) were randomized to receive either a closed incision negative pressure wound therapy (ciNPWT; PREVENA) device or a standard-of-care silver-impregnated occlusive wound dressing. The primary outcome of interest was the incidence of wound complications. Secondary outcomes included the rates or re-admission and re-operation. Follow up was performed at 2 weeks, 4 weeks, and 12 weeks post-surgery. Results revealed a significantly favourable rate of wound complications in the ciNPWT group compared to the control group at 2 weeks and overall. The rate of re-operation was significantly in favour of the ciNPWT group at 12 weeks and overall compared to the control group. Two cases of infection were reported in the ciNPWT group, whilst 8 cases were reported in the control group. No differences were observed in the rate of re-admission between the two groups.