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Background Prevention of surgical site infection (SSI) is a public health challenge. Our objective was to determine if prophylactic negative-pressure wound therapy (pNPWT) allows preventing SSI after laparotomy. Methods Medline, Embase, and Web of Science were searched on 6 October 2019 for original studies reporting the incidences of SSI in patients undergoing open abdominal surgery with and without pNPWT. Risk differences (RDs) between control and pNPWT patients and risk ratios (RRs) for SSI were obtained using random-effects models. Results Twenty-one studies (2930 patients, 5 randomized controlled trials [RCTs], 16 observational studies) were retained for the analysis. Pooled RD between patients with and without pNPWT was −12% (95% confidence interval [CI], −17% to −8%; I 2 = 57%; P  < .00001) in favor of pNPWT. That risk difference was −12% (95% CI, −22% to −1%; I 2 = 69%; P  = .03) when pooling only RCTs (792 patients). pNPWT was protective against the incidence of SSI with a RR of 0.53 (95% CI,.40–.71; I 2 = 56%; P  < .0001). The effect on pNPWT was more pronounced in studies with an incidence of SSI ≥20% in the control arm. The preventive effect of pNPWT on SSI remained after correction for potential publication bias. However, when pooling only high-quality observational studies (642 patients) or RCTs (527 patients), significance was lost. Conclusions Existing studies suggest that pNPWT on closed wounds is protective against the occurrence of SSI in abdominal surgery, but these findings need to be confirmed by more high-quality evidence, preferentially in subgroups of patients with an incidence of SSI ≥20% in the control arm. [ABSTRACT FROM AUTHOR]

Borehole breakouts and drilling-induced tensile fractures (DITFs) were interpreted in 61 wells in the Cooper Basin indicating an average maximum horizontal stress orientation of 101°N. A total of 890 borehole breakouts and 608 DITFs were interpreted in the Cooper Basin. The approximately east–west maximum horizontal stress orientation is consistent over much of the basin, except in the Patchawarra Trough where maximum horizontal stress rotates to a northwest–southeast orientation. This rotation in maximum horizontal stress orientation is consistent within situstress data to the northwest of the Cooper Basin. The stress field in the Cooper Basin appears to mark the apex of a major horseshoe-shaped rotation in maximum horizontal stress direction across central eastern Australia. Finite element modelling of thein situstress field of the Indo–Australian Plate (IAP) using a range of plate-scale tectonic forces is able to match the regional maximum horizontal stress orientation over most of Australia reasonably well, including the mean east–west maximum horizontal stress orientation in the Cooper Basin. However, plate boundary–scale modelling does not adequately match the horseshoe-shaped stress rotation across central eastern Australia. The average east–west maximum horizontal stress orientation in the Cooper Basin indicates that stresses from tensional forces acting along the Tonga–Kermadec subduction zone are not transmitted into the interior of the Australian plate. The majority of the tensional forces associated with the Tonga–Kermadec subduction zone are most likely accommodated along the numerous spreading centres within the Lau–Havre backarc basin. A number of more localized stress anomalies have also been identified. These cannot be explained by plate-scale tectonic forces and are possibly a result of geological structure and/or density contrasts locally perturbing the stress field. [ABSTRACT FROM AUTHOR]