Closed Incision Negative Pressure Therapy Reduces Donor Site Complications in Head and Neck Reconstruction

Closed incision negative pressure therapy (ciNPT) has been associated with a reduced risk of surgical wound complications, but its effectiveness in head and neck reconstruction has not been fully studied. This study aimed to evaluate the association between ciNPT use and the incidence and severity of complications at flap harvest sites that were primarily closed.

A retrospective analysis was conducted on 85 patients who underwent head and neck reconstruction at a single institution between 2021 and 2024. Patients were divided into ciNPT (n = 46) and non-ciNPT (n = 39) groups. Rates of postoperative complications, including wound dehiscence, skin necrosis, surgical site infections (SSIs), hematomas, and seromas, occurring within 30 days were assessed. Multivariate logistic regression was used to identify risk factors and adjust for confounding variables.

Of 85 patients, 13 (15.3%) experienced complications, with significantly lower rates in the ciNPT group (4.3%) compared to the non-ciNPT group (28.2%). Non-ciNPT use was associated with a higher relative risk of complications compared with ciNPT use (adjusted OR: 7.942; 95% CI: 1.602-39.365; p = 0.011). In the ciNPT group, complications were limited to minor seromas (Clavien-Dindo grade I). In contrast, the non-ciNPT group had more severe complications, including wound dehiscence, skin necrosis, SSIs, seromas, and hematomas.

ciNPT was associated with lower incidence of complications at flap harvest sites in head and neck reconstruction. These findings highlight the potential benefits of ciNPT in improving postoperative wound outcomes. Further studies, including randomized controlled trials, are needed to confirm these results and refine ciNPT application.

umin.ac.jp/ctr Identifier: UMIN000056066.