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Updated: Aug 12, 2025

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A Randomized Study Comparing Closed-Incision Negative-Pressure Wound Therapy with Standard Care in Immediate Breast

Karolina Pieszko1,2,3, Konrad Pieszko4, Mateusz Wichtowski5

  • 1From the Clinic of General Surgery and Surgical Oncology.

Plastic and Reconstructive Surgery
|February 2, 2023
PubMed
Summary

Closed-incision negative-pressure wound therapy (ciNPWT) significantly reduced surgical site complications in breast reconstruction patients. This therapy also improved scar elasticity and skin temperature post-surgery.

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Area of Science:

  • Oncology
  • Plastic Surgery
  • Wound Care

Background:

  • Breast cancer is the most common non-skin cancer in women.
  • Preventing surgical site complications in immediate breast reconstruction (IBR) is vital.
  • Complications include acellular dermal matrices or prosthesis exposure and loss.

Purpose of the Study:

  • To assess the impact of closed-incision negative-pressure wound therapy (ciNPWT) versus standard dressings (ST) after IBR.
  • Evaluate effects on surgical-site complications, superficial skin temperature (SST), skin elasticity, and subjective scar quality.
  • Determine the potential benefit of prophylactic ciNPWT application.

Main Methods:

  • A multicenter randomized controlled study.
  • 60 adult female patients undergoing IBR with implants or expanders.
  • Data collected between January 2019 and July 2021.

Main Results:

  • ciNPWT significantly decreased surgical site complications within 1 year (20% vs. 60% for ST, P = 0.003).
  • ciNPWT resulted in more elastic scar tissue (P < 0.001).
  • SST was significantly higher in the ciNPWT group 1 week post-surgery (P = 0.006). Subjective scar outcomes were comparable.

Conclusions:

  • This is the first RCT showing ciNPWT reduces surgical site complications in IBR patients.
  • ciNPWT is a beneficial prophylactic method for IBR.
  • Consider ciNPWT for patients with a high probability of postoperative radiotherapy.