Managing Drainless Mastectomy With Closed Incision Negative Pressure Wound Therapy Using Full-coverage Foam Dressings

In the United Kingdom, the rise in simple mastectomies without drain placement has contributed to improving rates of day-case surgery. However, this practice has resulted in increased rates of symptomatic seromas and greater resource burden in clinics. For postoperative incision management, we have implemented the use of closed incision negative pressure therapy (ciNPT) with foam dressings that cover the entire incision and surrounding tissues. The aim of this study was to establish whether the use of full-coverage ciNPT after mastectomy reduced seroma-related interventions.

Seroma intervention data were collected for patients undergoing mastectomies at a single center. Thirty sequential patients with conventional dressings placed between December 2020 and May 2021 and 25 sequential patients with ciNPT with full-coverage dressings between August 2021 and January 2022 were included in the study.

There were 31 mastectomy cases in each arm (including bilateral cases). Twenty cases in the control group and 15 cases in the ciNPT group required a return to the clinic for seroma. In the control group, 16 incisions required at least 1 aspiration, versus 12 in the ciNPT group. Compared with the control group, the ciNPT group required fewer aspirations per mastectomy (P = 0.048) and had lower total aspiration volumes (P = 0.031).

In our clinic, nearly two-thirds of drainless mastectomy patients required postoperative visits for seromas. Patients managed with ciNPT dressings covering the entire breast required fewer seroma-related visits and experienced reduced total seroma volume.