One thousand five hundred and forty-eight patients presenting with a lower extremity fracture caused by major trauma received surgical intervention followed by surgical wound dressing with an incisional negative pressure wound therapy (iNPWT) device or with standard sterile dressing. The primary outcome of interest was the incidence of deep surgical site infection within the first 30 days post-operation. Secondary outcomes of interest included the Disability Rating Index (DRI), the EQ-5D quality of life measure, EQ-5D on a Visual Analog Scale (VAS), the patient and observer scar assessment scale, and the incidence of chronic neuropathic pain as determined by the Douleur Neuropathique Questionnaire. Results revealed no significant differences between the iNPWT and standard groups in all outcomes.