Objectives To establish the rate of surgical site infection in patients with endometrial carcinoma undergoing laparotomy using standard surgical dressings compared to those using negative wound pressure therapy (NPWT).

Methods Retrospective cohort analysis of 398 patients who underwent a laparotomy for endometrial carcinoma between 2013–2014 and 2018–2019 across three hospitals in New Zealand, to compare the effect of introduction of NPWT. SSI, wound dehiscence and return to theatre were compared between standard dressings and NPWT using logistic regression, controlled for grade of tumour, age, BMI, smoking status, diabetes and previous surgery.

Results There were 352 patients in the standard dressing group and 42 patients in the NPWT group with baseline difference in the smoking status and age. The mean age was 60 (range 25–91). The mean BMI was 37 (range 15–74). NPWT did not decrease the SSI rate (p=0.641) and return to theatre (0.226), but decreased the wound dehiscence rate (p=0.021, OR 2.773). Higher BMI was found to increase the SSI rate (p=0.001, OR 1.415).

Conclusions The results of this study suggest that negative pressure wound therapy does not decrease SSI rate, but decreases the wound dehiscence rate. Further randomised control trials in gynaecological oncology patients undergoing laparotomy are needed, especially for higher risk groups, such as obese patients.