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Development of a Benchtop Model for Evaluating the Compatibility of Wound Dressing Materials with Negative Pressure Wound Therapy Systems
Published on: May 2, 2025
246
Negative Pressure Wound Therapy with Instillation for Periprosthetic Infection after Breast Reconstruction: A
Madeline J O'Connor1, Kristin N Huffman1, Kelly Ho1
1From the Department of Surgery/Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Plastic and Reconstructive Surgery. Global Open
|November 7, 2024
Summary
Negative pressure wound therapy with instillation and dwell (NPWTi-d) aids breast reconstruction by improving implant pocket salvage rates. This therapy, combined with antibiotics, also reduces the time needed for reinserting implants after infection.
Area of Science:
- Plastic Surgery
- Wound Management
- Infectious Disease
Background:
- Periprosthetic infection is a common complication in breast reconstruction, potentially leading to implant loss and poor patient outcomes.
- Current management involves prosthesis removal, antibiotics, and delayed reconstruction.
- The adjunctive role of negative pressure wound therapy with instillation and dwell (NPWTi-d) in preserving the breast implant pocket was investigated.
Purpose of the Study:
- To evaluate the effectiveness of NPWTi-d in salvaging the breast pocket following periprosthetic infection.
- To assess the impact of NPWTi-d on the time to implant reinsertion.
- To analyze outcomes related to NPWTi-d use in breast reconstruction patients.
Main Methods:
- A systematic literature search was performed across major databases (PubMed, Cochrane, OVID, Scopus, Embase).
- Included were peer-reviewed English articles published between January 2004 and April 2023.
- Studies focused on NPWTi-d use in breast pockets with a history of periprosthetic infection.
Main Results:
- Six studies involving 115 patients and 122 breasts met the inclusion criteria.
- The overall breast pocket salvage rate using NPWTi-d was approximately 92%.
- Mean time to implant reinsertion ranged from 2.3 to 10.3 days, with high salvage rates observed for both implants and tissue expanders, and in irradiated and non-irradiated breasts.
Conclusions:
- Adjunctive NPWTi-d, alongside antibiotic therapy, is associated with high breast pocket salvage rates after periprosthetic infection.
- NPWTi-d may reduce the time required for subsequent implant reinsertion.
- Further large-scale prospective and randomized trials are necessary to optimize NPWTi-d's role in breast reconstruction outcomes.
