Perioperative Wound Management and Infection Prevention in Abdominal Surgery: A Systematic Review and Meta-Analysis

Xinda Tian

doi:10.3791/71817

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Research Article

Perioperative Wound Management and Infection Prevention in Abdominal Surgery: A Systematic Review and Meta-Analysis

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DOI:

10.3791/71817

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June 30th, 2026

Xinda Tian¹

¹Department of Urology, Jilin Province FAW General Hospital

Summary

Perioperative wound management and surgical site infection prevention strategies may reduce surgical site infection after abdominal surgery. This review reclassifies interventions by clinical mechanism, emphasizes the synthesis of verified event counts, and separates clinical findings from unsupported mechanistic interpretations.

Abstract

This study evaluated perioperative incisional wound management and surgical site infection (SSI) prevention interventions on wound-related outcomes after abdominal surgery. Following PRISMA 2020 guidance, PubMed, Embase, Web of Science, and Cochrane CENTRAL were searched for comparative studies published from January 2023 to March 2026. Eligible studies enrolled adults undergoing abdominal surgery and compared an incisional wound management or SSI prevention intervention with routine care, standard dressing, saline, placebo, preimplementation care, or another active comparator. Interventions were reclassified by dominant clinical mechanism as antiseptic or antimicrobial preparation, wound irrigation, closed incision negative pressure wound therapy, physical wound protection, or multimodal SSI prevention bundles. Nineteen comparative studies were included. After re-extraction of study-level event data, 18 studies with extractable denominators contributed to the SSI meta-analysis; the pooled random-effects risk ratio (RR) was 0.72 (95% confidence interval (CI), 0.58–0.90; p = 0.003; I² = 64%). Wound dehiscence, delayed healing, seroma, hospital stay, scar quality, pain, and quality-of-life outcomes were summarized narratively because definitions, scales, or event counts were not sufficiently comparable for reliable pooling. The available evidence suggests that perioperative wound management interventions may reduce SSI after abdominal surgery, but substantial clinical and methodological heterogeneity limits the certainty and generalizability of pooled estimates. Mechanistic explanations should be interpreted as hypothesis-generating unless directly supported by mechanistic measurements in the included studies.

Introduction

Abdominal surgery remains associated with clinically important incisional complications, including SSI, wound dehiscence, delayed healing, seroma, pain, readmission, and prolonged hospital stay¹^,²^,³. These complications increase patient burden and health-care costs and remain relevant even when operative technique, antimicrobial prophylaxis, and perioperative care pathways are optimized⁴. Therefore, improving incisional wound outcomes remains an important component of postoperative recovery after abdominal surgery.

Incisiona....