Die Einweg-Vakuumversiegelungstherapie zur Prävention von Wundheilungsstörungen bei primär verschlossenen Inzisionen
摘要
Postoperative wound healing disorders, particularly surgical site infections, cause substantial morbidity and high healthcare costs. Prophylactic negative pressure wound therapy (NPWT) on primarily closed incisions, especially as single use NPWT (sNPWT), has become established across several surgical disciplines; however, standardized, practice-oriented recommendations for indications and application are so far lacking in Germany.
ObjectiveWhich international recommendations exist for prophylactic sNPWT use and how can they be adapted to the German healthcare setting?
Material and methodsA structured literature search (PubMed, Cochrane Library, Google Scholar; 2015–2025) identified international guidelines, recommendations and consensus papers on prophylactic sNPWT. Recommendations were comparatively analyzed. An interdisciplinary expert panel (vascular, cardiac, plastic reconstructive, orthopedic and trauma surgery) developed practice-oriented recommendations across three moderated consensus rounds (RAND/UCLA method).
ResultsOut of 19 identified documents, 7 explicitly addressed sNPWT. All recommended its use for high-risk patients but varied in risk definitions (e.g., body mass index, BMI ≥ 30–≥ 40 kg/m2), exudate thresholds and pressure levels. Only one document (NICE) was based on an independent systematic review of the evidence. The panel endorsed 21 consensus-based statements (19 with strong consensus) and developed a practice-oriented risk score comprising 14 moderate and 6 major risk factors for Germany.
ConclusionThese recommendations provide a structured decision support framework for prophylactic sNPWT in routine German healthcare and can serve as a basis for discussion for the initiation of national guidelines by the relevant professional societies.