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Published on: May 17, 2024
Initial Experience Using Closed Incision Negative Pressure Therapy after Immediate Postmastectomy Breast
Allen Gabriel1, Steven R Sigalove1, G Patrick Maxwell1
1PeaceHealth Medical Group, Vancouver, Wash.; DuPage Medical Group, Glen Ellyn, Ill.; and Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, Calif.
Closed incision negative pressure therapy (ciNPT) shows promise in improving healing outcomes for immediate postmastectomy breast reconstruction patients. This therapy may reduce complications and shorten drain duration, warranting further investigation.
Area of Science:
- Plastic Surgery
- Surgical Innovation
- Wound Management
Background:
- Immediate postmastectomy breast reconstruction offers aesthetic benefits but faces high complication rates.
- Common complications include seroma, dehiscence, infection, and necrosis.
- Closed incision negative pressure therapy (ciNPT) is a potential adjunct for managing surgical incisions.
Purpose of the Study:
- To evaluate the efficacy of ciNPT with a customizable dressing in immediate postmastectomy breast reconstruction.
- To assess complication rates and wound healing in patients undergoing 2-stage expander/implant reconstruction with ciNPT.
- To determine the impact of ciNPT on drain management and removal time.
Main Methods:
- A prospective study involving 13 patients (25 breasts) undergoing immediate postmastectomy reconstruction.
- Application of ciNPT (-125 mmHg) with a customizable dressing to closed incisions immediately after surgery.
- Follow-up at 3 months to assess wound healing and complications.
Main Results:
- 96% (24/25) of breasts achieved successful wound healing at 3 months.
- One case of delayed hematoma and three cases of superficial dehiscence were successfully managed.
- One instance of flap necrosis required surgical revision.
- Average drain removal time was reduced to 8.2 days from an estimated 12-14 days.
Conclusions:
- ciNPT with customizable dressings appears to be a safe and effective option for immediate postmastectomy breast reconstruction.
- The therapy demonstrated high healing rates and potential benefits in reducing drain duration.
- Larger studies are recommended to further validate these findings and explore different dressing types.
