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Closed Incision Negative Pressure Therapy in Oncoplastic Breast Surgery: A Comparison of Outcomes

Wareham, Carly M
Karamchandani, Manish M
Ku, Gabriel De La Cruz
Gaffney, Kerry
Sekigami, Yurie
Persing, Sarah M
Homsy, Christopher
Nardello, Salvatore
Chatterjee, Abhishek
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Journal Article
Publication Date
2023-04-25
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Abstract

Background:

We aim to discern the impact of closed incision negative pressure therapy (ciNPT) on wound healing in the oncoplastic breast surgery population.

Methods:

A retrospective analysis was conducted on patients who underwent oncoplastic breast surgery with and without ciNPT in a single health system over 6 years. Oncoplastic breast surgery was defined as breast conservation surgery involving partial mastectomy with immediate volume displacement or replacement techniques. Primary outcomes were rates of clinically significant complications requiring either medical or operative intervention, including seroma, hematoma, fat necrosis, wound dehiscence, and infection. Secondary outcomes were rates of minor complications.

Results:

ciNPT was used in 75 patients; standard postsurgical dressing was used in 142 patients. Mean age (P = 0.73) and Charlson Comorbidity Index (P = 0.11) were similar between the groups. The ciNPT cohort had higher baseline BMIs (28.23 ± 4.94 versus 30.55 ± 6.53; P = 0.004), ASA levels (2.35 ± 0.59 versus 2.62 ± 0.52; P = 0.002), and preoperative macromastia symptoms (18.3% versus 45.9%; P ≤ 0.001). The ciNPT cohort had statistically significant lower rates of clinically relevant complications (16.9% versus 5.3%; P = 0.016), the number of complications (14.1% versus 5.3% with one complication, 2.8% versus 0% with >2; P = 0.044), and wound dehiscence (5.6% versus 0%; P = 0.036).

Conclusions:

The use of ciNPT reduces the overall rate of clinically relevant postoperative complications, including wound dehiscence. The ciNPT cohort had higher rates of macromastia symptoms, BMI, and ASA, all of which put them at increased risk for complications. Therefore, ciNPT should be considered in the oncoplastic population, especially in those patients with increased risk for postoperative complications.

Source

Wareham CM, Karamchandani MM, Ku GC, Gaffney K, Sekigami Y, Persing SM, Homsy C, Nardello S, Chatterjee A. Closed Incision Negative Pressure Therapy in Oncoplastic Breast Surgery: A Comparison of Outcomes. Plast Reconstr Surg Glob Open. 2023 Apr 25;11(4):e4936. doi: 10.1097/GOX.0000000000004936. PMID: 37113306; PMCID: PMC10129093.

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DOI
10.1097/GOX.0000000000004936
PubMed ID
37113306
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Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.