Effects of Perioperative Wound-Management and Infection-Prevention Interventions on Incisional Wound Healing in Abdominal Surgery: A Systematic Review and Meta-Analysis

This study aimed to evaluate the effects of perioperative incisional wound-management and surgical site infection (SSI)-prevention interventions on wound-related outcomes after abdominal surgery. In accordance with the PRISMA 2020 statement1, PubMed, Embase, Web of Science, and Cochrane CENTRAL were searched for comparative studies published between January 2023 and 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, pre-implementation 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 verified re-extraction of study-level event data, 18 studies with extractable denominators contributed to the SSI meta-analysis; the pooled random-effects risk ratio was 0.72 (95% 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-count reporting 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.