Negative Pressure Dressings Do Not Decrease SSI in Emergency Laparotomy

Group STS, Atherton K, Brown J, et al. Negative Pressure Dressings to Prevent Surgical Site Infection after Emergency Laparotomy: The SUNRRISE Randomized Clinical Trial. JAMA. 2025; in press.

Surgical site infections (SSI) occur in up to 40% of patients undergoing emergency laparotomy. Use of negative pressure dressings (iNPWT) to reduce the risk of surgical site infections is included as a conditional recommendation in the World Health Organization SSI prevention guidelines, but evidence supporting use of these devices is weak.

This randomized trial (n = 840) compared iNPWT to surgeons’ choice of dressing in patients undergoing emergency laparotomy with primary skin closure. Patients from hospitals in Australia and the UK were recruited to the study. The primary event of interest was diagnosis of SSI up to 30 days after the index procedure; secondary outcomes included postoperative complications, length of hospital stay, hospital readmission for wound complications, pain, and quality of life.

SSI was diagnosed in 28.4% of the iNPWT group and 27.4% of the control group. The lack of a difference in risk of SSI was consistent when patients were classified according to degree of contamination and presence of an intestinal stoma. No significant differences were observed in other outcomes.

The authors concluded that iNPWT did not prevent SSI more than other dressings.