Abstract
Background: Closed incision negative pressure therapy (ciNPT) may reduce the rate of wound complications and promote healing of the incisional site. We report our experience with this dressing in breast reconstruction patients with abdominal free flap donor sites. Methods: A retrospective cohort study was conducted of all patients who underwent breast reconstruction using abdominal free flaps (DIEP, MS-TRAM) at a single institution (Royal Melbourne Hospital, Victoria) between 2016 and 2021. Results: 126 female patients (mean age: 50 ± 10 years) were analysed, with 41 and 85 patients in the ciNPT (Prevena) and non-ciNPT (Comfeel) groups, respectively. There were reduced wound complications in almost all outcomes measured in the ciNPT group compared with the non-ciNPT group; however, none reached statistical significance. The ciNPT group demonstrated a lower prevalence of surgical site infections (9.8% vs. 11.8%), wound dehiscence (4.9% vs. 12.9%), wound necrosis (0% vs. 2.4%), and major complication requiring readmission (2.4% vs. 7.1%). Conclusion: The use of ciNPT for abdominal donor sites in breast reconstruction patients with risk factors for poor wound healing may reduce wound complications compared with standard adhesive dressings; however, large scale, randomised controlled trials are needed to confirm these observations. Investigation of the impact of ciNPT patients in comparison with conventional dressings, in cohorts with equivocal risk profiles, remains a focus for future research.
Highlights
The abdominal free flap is considered the gold standard in most cases of breast reconstruction but may be associated with significant wound complications
We assessed whether donor site wound management with Closed incision negative pressure therapy (ciNPT) is associated with reduced wound complications in breast reconstruction patients with abdominal free flaps compared with standard adhesive wound care
Standard wound care for abdominal free flap donor sites involves the use of a hydrocolloid dressing (Comfeel® manufactured by Coloplast, Melbourne, VIC, Australia)
Summary
The abdominal free flap is considered the gold standard in most cases of breast reconstruction but may be associated with significant wound complications. Complications such as surgical site infections (SSI), wound dehiscence and tissue necrosis contribute to morbidity, health care costs and are burdensome for patients and surgeons. Creating a suction force allows the drainage of excess interstitial fluid, reducing both physical and chemical deterrents of wound healing. Whilst this is not a new concept, its clinical success over the years has encouraged clinicians to trial the same technique to closed incisional wounds. Extensive research performed by Ogawa et al has demonstrated that minimizing skin
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
