134P - The negative pressure therapy with PICO as a prevention of surgical site infection in high risk patients undergoing breast surgery

Abstract

Background: The negative pressure therapy (NPWT) is usually used to treat difficult and chronic wounds. Among NPWT devices, some of them, like PICO, have a proven utility as a prophylaxis against surgical wound complications in high risk patients. PICO is a fixed intensity instrument, working with a continuous -80mmHg pressure over the wound. Methods: In the MARIPI study 100 high risk patients have been enrolled, 50 of them received a PICO plaster directly in the surgical room. We have then evaluated the difference in incidence of surgical wound complications between the case and control groups.Patients have been considered eligible to our study in the period 01.01.2016 to 01.01.2017 due to one or more of these following risk factors: diabetes, heavy smoke (more than 10 cigarettes per day), previous radiotherapy in the thoracic fields, skin diseases, vascular or cardiac alterations. Results: After a deep results analysis, significant difference in the wound infection rate comes out: 1(4.3% ) in the PICO group vs 3 (13,0%) in control group. The same consideration can be made concerning the wound dehiscences: 2 (8.7%) in the PICO group, 6 in the control one (26,1%). (p = 0.093) The whole number of patients’ clinical checks was 113 in the PICO group and 150 in the control one (p < 0.001) Medications with negative pressure reduce the wound infection rate down to about 50 and the dehiscence rate of about 66%, and this can lead to a costs reduction even considering the cost of 200$ (about 130 €) for any PICO medication. Conclusions: In our opinion, similarly to what may be found in the literature concerning other kinds of surgery, the use of PICO for risk reduction is justified in high risk patients. Further and broader randomized studies are in any case needed to better clarify the role of the therapies with negative pressure in breast cancer patients. Legal entity responsible for the study: AUSL Romagna. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.