Negative-Pressure Wound Therapy: Where it Works and Where it Doesn’t! .

Negative-pressure wound therapy has been widely adopted in orthopedic and trauma surgery with the hope that subatmospheric pressure and improved fluid removal might lower surgical-site infections. An updated review of 13 trials suggests a small, statistically significant reduction in overall infection risk, but the effect is borderline and unlikely to be clinically meaningful. Benefits were limited to open-fracture trauma, with no signal of advantage in arthroplasty or fasciotomy, and no reduction in deep infections across any subgroup. Length of stay was slightly shorter with NPWT, though evidence quality was low. Costs were consistently much higher than standard dressings, leaving questions about whether the modest effects justify the added expense.