Outcomes of progressive tension donor-site closure in abdominal-based autologous breast reconstruction

Abstract

The use of progressive tension sutures (PTSs) for drain-free abdominoplasty closure has been well published in the esthetic literature and found to be effective at reducing abdominal drainage without a worse complication profile. This research aims to evaluate the outcomes of incorporating PTS into donor-site closures for abdominal-based breast reconstruction. A retrospective chart review was performed evaluating patients at the University of Chicago Medicine, who underwent autologous breast reconstruction and either PTS closure or standard abdominal closure between 2018 and 2021. A total of 100 patients were included with 50 patients receiving PTS closure and 50 with traditional abdominal closures. Patient demographics, including age (p=0.82), body mass index (BMI; p=0.17), diabetes (p=1.00), tobacco use (p=0.15), and chemotherapy (p=1.00) did not significantly differ. Total drain output over the first 72h was significantly lower in the PTS group compared with the standard closure (SC) group (p=0.00005). Mean duration of drain placement was shorter by 2 days in the PTS group, but this did not reach significance (p=0.08). Overall complication rates were lower in the PTS group (p=0.03), however, no difference was appreciated when separately assessing for seromas (p=1.00), hematomas (p=1.00), wound dehiscence (p=0.58), or surgical-site infections (p=1.00). More abdominal revisions were observed in the SC group, however, this did not reach significance (p=0.15) CONCLUSION: The use of PTS with placement of a single drain is a safe option for donor-site closure, and is a compelling technique for patients undergoing abdominal-based breast reconstruction.