Abstract

BackgroundNegative pressure wound therapy (NPWT) for postsurgical incision treatment has demonstrated benefits. A prospective randomized study was developed including 32 patients who underwent bilateral breast reduction mammoplasty. Patients served as their own control and received NPWT to one breast and fixation strips to the other breast.MethodsThe primary outcome was the number of wound healing complications within 21 days when comparing NPWT treatment with fixation strips. The secondary outcome was aesthetic appearance and quality of scarring using questionnaires [visual analogue scale (VAS) and Patient and Observer Scar Assessment Scale (POSAS)] scored at day 42-, 90-, 180- and 365-day follow-up using additional scar measurement modalities, such as viscoelasticity.ResultsFor the 32 included patients, the number of wound complications was significantly lower (p < 0.004) for the NPWT treated sites compared to fixation strips. POSAS and VAS scores at 42 and 90 days revealed a significantly better quality of scarring in the NPWT treatment breasts than in fixation strips. At 180-day follow-up, there was a significant improvement in VAS scores, as well as a comparable improvement in POSAS scores. No consistent significant improvement in scar quality was demonstrated with the assays that were used.ConclusionsOur study showed less complications and a significant improvement in quality of scarring in favor of the NPWT-treated sites. The results indicate NPWT to be an attractive option for these patients.Level of Evidence IIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Highlights

  • Breast reduction is a common cosmetic surgical procedure to reduce the size of the breast and to overcome discomfort caused by oversized, ill-shaped and hanging breasts [1]

  • The primary outcome was the number of wound healing complications within 21 days when comparing Negative pressure wound therapy (NPWT) treatment with fixation strips

  • The authors stated: ‘‘given the cost and widespread use of NPWT, there is an urgent need for suitably powered, high-quality trials to evaluate the effects of the newer NPWT products that are designed for use on clean, closed surgical incisions’’ [33]

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Summary

Introduction

Breast reduction is a common cosmetic surgical procedure to reduce the size of the breast and to overcome discomfort caused by oversized, ill-shaped and hanging breasts [1]. The most common complication is delayed wound healing, and other complications include hematoma, fat necrosis, nipple necrosis, cellulitis and fungal dermatitis [4,5,6]. Negative pressure wound therapy (NPWT) refers to the controlled application of sub-atmospheric pressure to promote wound healing and has been applied in a wide array. Negative pressure wound therapy (NPWT) for postsurgical incision treatment has demonstrated benefits. A prospective randomized study was developed including 32 patients who underwent bilateral breast reduction mammoplasty. Patients served as their own control and received NPWT to one breast and fixation strips to the other breast

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