Closed Incision Negative Pressure Therapy for the Recipient Site in Head and Neck Reconstruction

This study aimed to evaluate the benefits of recipient site of closed incision negative pressure therapy (ciNPT) on postoperative complications in head and neck reconstruction.

A single-center retrospective observational study was conducted on patients who underwent head and neck reconstruction for both benign and malignant disease using pedicled or free tissue transfers between November 2023 and September 2024.

A tertiary care institution.

Patients were divided into ciNPT and non-ciNPT groups. 30-day postoperative complication rates, including skin necrosis, surgical site infection (SSI), hematoma, lymphorrhea, anastomotic leakage, and flap vascular compromise, were compared between groups.

44 patients (median age: 68.0, female: 38.6%) were included in the analyses (21 ciNPT, 23 non-ciNPT). The ciNPT group had a higher median intraoperative blood loss (510 vs 175 mL; P = .004) and higher rates of intra/postoperative blood transfusion (5 vs 0; P = .019). A total of 39 patients underwent free tissue transfer, comprising 17 in the ciNPT group (81.0%) and 22 in the non-ciNPT group (95.7%). Clavien-Dindo grade IIIa complications occurred in 19.0% of ciNPT and 21.7% of non-ciNPT cases (P = 1.000), while grade IIIb complications occurred in 19.0% and 13.0%, respectively (P = .693). Overall, no significant differences were found between groups across complication categories.

Although overall complication rates were comparable between the 2 groups, this study emphasizes practical techniques for the clinical application of ciNPT in complex reconstruction cases. Larger, prospective, multi-center studies are warranted to validate its benefits and optimize clinical use.

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