Publication:

A systematic review and meta-analysis of therapeutic strategies for postoperative abdominal wound infection

Postoperative abdominal wound infections remain a major cause of morbidity, prolonged hospitalization, and increased healthcare costs worldwide. Despite advances in surgical techniques and infection prevention, controversy persists regarding optimal management strategies, leading to variations in clinical practice. This systematic review and meta-analysis aimed to evaluate current evidence on the management of postoperative abdominal wound infections, focusing on medical, surgical, and adjunctive interventions that improve outcomes and reduce recurrence. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library for studies published between 2010 and 2025. Eligible studies included randomized controlled trials (RCTs), cohort studies, observational studies, systematic reviews, and clinical guidelines addressing postoperative abdominal wound infection management. Data extraction and quality assessment were independently performed by two reviewers. A total of 27 studies were included: 2 RCTs, 4 cohort studies, 4 prospective observational studies, 3 cross-sectional studies, 2 systematic reviews/meta-analyses, 3 guidelines, 4 narrative reviews, 3 quality-improvement studies, and 2 integrative or scoping reviews. Evidence consistently demonstrated that effective management depends on early diagnosis, prompt wound debridement, appropriate antibiotic therapy, and advanced wound care techniques such as negative pressure wound therapy (NPWT) and antimicrobial dressings. Multidisciplinary care and infection-prevention strategies were also associated with improved outcomes. Overall, management of postoperative abdominal wound infections requires a multimodal, patient-centered approach integrating surgical intervention, optimized antimicrobial therapy, and advanced wound care. NPWT appears to provide the greatest benefit as an adjunctive therapy. Further high-quality RCTs are needed to establish standardized treatment protocols and strengthen evidence for emerging therapies.