Abstract
BackgroundDue to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty.Patients and Methods26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated.ResultsNone of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery.ConclusionThe piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes.Level of Evidence IVThis 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 Table of Contents or the online Instructions to Authors www.springer.com/00266.
Highlights
Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide
We aimed to evaluate the role of portable incisional negative pressure wound therapy (piNPWT) in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty
We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes
Summary
Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. Bariatric surgery and diet-related weight loss reduce significantly comorbidity of obese patients improving their life expectancy [2, 3]. The accumulation of excess cutaneous tissue severely impacts massive weight loss (MWL) patients’ quality of life, preventing them from performing social and physical activity. More of 30% of the American population is obese and almost 300,000 patients per year undergo bariatric surgery [6, 7]. Patients with loose and hanging skin should undergo a brachioplasty procedure associated with liposuction in the presence of severe adiposity [8, 11, 12]. In 2017, 18033 arm lift procedures have been performed in the U.S, with a 5235% increase from 2000 [14]
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