Objective:
Deep sternal wound infection (DSWI) is a severe and potentially life-threatening complication following cardiovascular surgery. Negative pressure wound therapy (NPWT) has emerged as a promising therapeutic bridging option for DSWI. In this systematic review and meta-analysis, we aimed to evaluate the impact of NPWT on clinical outcomes in patients with DSWI.

Material and Methods:
A comprehensive literature search was conducted according to the PRISMA guideline in electronic databases, including PubMed, Embase, and Cochrane Library. A total of 303 studies were initially identified, of which 36 retrospective non-randomized controlled studies were included in the final analysis. Data extraction was performed independently by two reviewers, and risk of bias was assessed by ROBINS-I tool. The primary outcomes assessed were mortality rate and reinfection rate. The secondary outcomes assessed were length of hospital stay and ICU stay.

Results:
Our systematic review identified a total of 36 studies, comprising 3,609 patients with DSWI who received treatment. The meta-analysis revealed that NPWT was associated with a significant reduction in mortality rate (RR 0.46, 95% CI 0.35-0.61) compared to conventional wound management. Furthermore, pooling of these studies showed that recurrence was less common among patients treated with NPWT compared to those treated with conventional wound management (RR 0.37, 95% CI: 0.22-0.64).

Conclusions:
This systematic review and meta-analysis provide compelling evidence that negative pressure wound therapy (NPWT) is a highly effective optional bridging treatment for patients with deep sternal wound infection (DSWI) following cardiovascular surgery.

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