Introduction <p>Postoperative wound complications — including surgical site infection (SSI), cerebrospinal fluid (CSF) leakage, and wound dehiscence — remain a significant challenge following surgery for spinal dysraphism, particularly in neonates and infants. Closed incisional negative pressure wound therapy (ciNPWT) has demonstrated benefit in several surgical subspecialties; however, evidence regarding its routine use in pediatric spinal dysraphism surgery is limited.</p> Methods <p>A retrospective review was conducted of all pediatric patients (age &lt; 18 years) who underwent surgery for spinal dysraphism and received ciNPWT as part of postoperative wound management at King Chulalongkorn Memorial Hospital between June 2020 and March 2024. Primary outcomes included postoperative wound complications (SSI, CSF leakage, wound dehiscence, and wound necrosis) within 30 days of surgery. The number of postoperative dressing changes was recorded as a secondary outcome and surrogate marker of wound care burden.</p> Results <p>A total of 28 patients were included: 8 with open spinal dysraphism (myelomeningocele, myeloschisis, or hemimyelomeningocele) and 20 with closed spinal dysraphism or related conditions (including 2 pygopagus conjoined twins). The median number of dressing changes was 3 (range 3–5) for open dysraphism and 2 (range 1–2) for closed dysraphism. Primary wound closure was achieved in all cases. No postoperative wound complications — including SSI, CSF leakage, wound dehiscence, or wound necrosis — were observed during the follow-up period.</p> Conclusion <p>Closed incisional negative pressure wound therapy appears to be a safe and effective adjunct for postoperative wound management in pediatric spinal dysraphism surgery, demonstrating favorable wound outcomes across both open and closed dysraphism types, including complex high-risk cases.</p>