Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review

Khaled Alsawair; Sultan Ayed K Alanazi; Ahmed Hamoud E Alkhaldi; Yaqoub Ali O Alharbi; Abdulkarem Naif Shaya Aldossari; Talal Bader A Almugharriq; Ali Nemer M Alshaqi; Faisal Musafiq A Alruwaili; Fahad Suhayman R Alanazi

doi:10.24911/IJMDC.51-1760437508

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Online Published: 29 Nov 2025

IJMDC. 2025; 9(11): 2902-2908

doi: 10.24911/IJMDC.51-1760437508

Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review

Khaled Alsawair, Sultan Ayed K Alanazi, Ahmed Hamoud E Alkhaldi, Yaqoub Ali O Alharbi, Abdulkarem Naif Shaya Aldossari, Talal Bader A Almugharriq, Ali Nemer M Alshaqi, Faisal Musafiq A Alruwaili, Fahad Suhayman R Alanazi.

Abstract
Complex surgical and traumatic wounds carry high infection risk, prolonged healing, and substantial resource use. Negative pressure wound therapy with instillation and dwell (NPWTi-d) augments standard NPWT by intermittently instilling topical solutions to improve wound cleansing and reduce bioburden, but its comparative effectiveness remains uncertain. We conducted a PRISMA-2020–compliant systematic review of adults with complex surgical or traumatic wounds, searching multiple databases from 1 January 2010 through 4 November 2025 for randomized controlled trials and systematic reviews/meta-analyses directly comparing NPWTi-d with standard NPWT. Two reviewers independently screened, extracted, and appraised risk of bias (RoB 2 for RCTs; ROBIS for reviews). Six studies (3 RCTs, 3 systematic reviews/meta-analyses; 825 participants) met strict inclusion criteria. Across studies, NPWTi-d was associated with fewer surgical procedures and greater post-treatment wound area reduction than standard NPWT, while time to definitive closure showed mixed results. Measures of bioburden consistently favored NPWTi-d, and skin maceration was the most frequently reported adverse event. Overall, NPWTi-d appears to offer procedural efficiency and enhanced bacterial clearance particularly in contaminated wounds though benefits for closure time remain inconsistent; larger, standardized RCTs are needed to clarify effects on time to closure and patient-centered outcomes and to define optimal instillation protocols.

Key words: Efficacy , negative pressure , wound therapy , instillation , complex surgical and traumatic wound management , systematic review.

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Pubmed Style

Alsawair K, Alanazi SAK, Alkhaldi AHE, Alharbi YAO, Aldossari ANS, Almugharriq TBA, Alshaqi ANM, Alruwaili FMA, Alanazi FSR. Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. IJMDC. 2025; 9(11): 2902-2908. doi:10.24911/IJMDC.51-1760437508

Web Style

Alsawair K, Alanazi SAK, Alkhaldi AHE, Alharbi YAO, Aldossari ANS, Almugharriq TBA, Alshaqi ANM, Alruwaili FMA, Alanazi FSR. Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. https://www.ijmdc.com/?mno=290223 [Access: June 23, 2026]. doi:10.24911/IJMDC.51-1760437508

AMA (American Medical Association) Style

Alsawair K, Alanazi SAK, Alkhaldi AHE, Alharbi YAO, Aldossari ANS, Almugharriq TBA, Alshaqi ANM, Alruwaili FMA, Alanazi FSR. Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. IJMDC. 2025; 9(11): 2902-2908. doi:10.24911/IJMDC.51-1760437508

Vancouver/ICMJE Style

Alsawair K, Alanazi SAK, Alkhaldi AHE, Alharbi YAO, Aldossari ANS, Almugharriq TBA, Alshaqi ANM, Alruwaili FMA, Alanazi FSR. Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. IJMDC. (2025), [cited June 23, 2026]; 9(11): 2902-2908. doi:10.24911/IJMDC.51-1760437508

Harvard Style

Alsawair, K., Alanazi, . S. A. K., Alkhaldi, . A. H. E., Alharbi, . Y. A. O., Aldossari, . A. N. S., Almugharriq, . T. B. A., Alshaqi, . A. N. M., Alruwaili, . F. M. A. & Alanazi, . F. S. R. (2025) Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. IJMDC, 9 (11), 2902-2908. doi:10.24911/IJMDC.51-1760437508

Turabian Style

Alsawair, Khaled, Sultan Ayed K Alanazi, Ahmed Hamoud E Alkhaldi, Yaqoub Ali O Alharbi, Abdulkarem Naif Shaya Aldossari, Talal Bader A Almugharriq, Ali Nemer M Alshaqi, Faisal Musafiq A Alruwaili, and Fahad Suhayman R Alanazi. 2025. Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2902-2908. doi:10.24911/IJMDC.51-1760437508

Chicago Style

Alsawair, Khaled, Sultan Ayed K Alanazi, Ahmed Hamoud E Alkhaldi, Yaqoub Ali O Alharbi, Abdulkarem Naif Shaya Aldossari, Talal Bader A Almugharriq, Ali Nemer M Alshaqi, Faisal Musafiq A Alruwaili, and Fahad Suhayman R Alanazi. "Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review." International Journal of Medicine in Developing Countries 9 (2025), 2902-2908. doi:10.24911/IJMDC.51-1760437508

MLA (The Modern Language Association) Style

Alsawair, Khaled, Sultan Ayed K Alanazi, Ahmed Hamoud E Alkhaldi, Yaqoub Ali O Alharbi, Abdulkarem Naif Shaya Aldossari, Talal Bader A Almugharriq, Ali Nemer M Alshaqi, Faisal Musafiq A Alruwaili, and Fahad Suhayman R Alanazi. "Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review." International Journal of Medicine in Developing Countries 9.11 (2025), 2902-2908. Print. doi:10.24911/IJMDC.51-1760437508

APA (American Psychological Association) Style

Alsawair, K., Alanazi, . S. A. K., Alkhaldi, . A. H. E., Alharbi, . Y. A. O., Aldossari, . A. N. S., Almugharriq, . T. B. A., Alshaqi, . A. N. M., Alruwaili, . F. M. A. & Alanazi, . F. S. R. (2025) Efficacy of negative pressure wound therapy with instillation compared to standard negative pressure wound therapy for complex surgical and traumatic wound management: systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2902-2908. doi:10.24911/IJMDC.51-1760437508

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