Abstract
Negative pressure wound therapy (NPWT) is usually applied in wound management and soft-tissue salvage after the development of complications. However, immediate postoperative application of NPWT over the flap coverage is seldom reported. We evaluate the effectiveness of immediate postoperative application of NPWT following fasciocutaneous or muscle flap coverage for lower leg reconstruction. A retrospective review of patients who underwent either fasciocutaneous or muscle flap coverage of lower leg soft-tissue defects applied with NPWT immediately after surgery was conducted in a level I trauma center. Sixteen patients, with an average age of 51.2 years, were included in the study. Nine patients had trauma-related soft-tissue loss, six had subsequent soft-tissue defects after debridement, and one had burn injury. Two patients had been treated with free anterolateral thigh flaps, 11 with pedicle flaps, and three with muscle flaps. All flaps survived except for those in two patients with venous congestion on postoperative day 1, which needed further debridement and skin grafting. Therefore, the use of immediate incisional NPWT is an alternative for wound care following flap coverage. The U-shaped design allows easy flap observation and temperature check. Furthermore, this method eliminates any concerns of vascular pedicle compression under negative pressure.
Highlights
Negative pressure wound therapy (NPWT) is usually applied in wound management and soft-tissue salvage after the development of complications
NPWT can provide cover for wounds under sterile conditions and potentially delay flap coverage until a healthier wound bed is formed. This method promotes wound healing by enhancing the blood supply to the wound bed before flap reconstruction, which is especially beneficial in the case of exposed fractures, highly contaminated wounds, chronic wounds with reduced healing potential, and burns[3]
Since NPWT can improve postoperative venous congestion, which is one of the most common causes of flap failure, immediate postoperative application of NPWT coupled with flap coverage can be c onsidered[17,18,19]
Summary
Negative pressure wound therapy (NPWT) is usually applied in wound management and soft-tissue salvage after the development of complications. Immediate postoperative application of NPWT over the flap coverage is seldom reported. We evaluate the effectiveness of immediate postoperative application of NPWT following fasciocutaneous or muscle flap coverage for lower leg reconstruction. A retrospective review of patients who underwent either fasciocutaneous or muscle flap coverage of lower leg soft-tissue defects applied with NPWT immediately after surgery was conducted in a level I trauma center. This study evaluates the effectiveness of immediate postoperative application of NPWT following fasciocutaneous or muscle flap coverage for lower leg reconstruction. It describes our own standard practice of NPWT application in a case series
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