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Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction
BACKGROUND: Closed-incision negative pressure wound therapy (ciNPWT) has shown promise in reducing surgical wound complications. Among its numerous benefits, it allows for exudate management and tension offloading from wound edges. The purpose of this systematic review and meta-analysis was to asses...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561809/ https://www.ncbi.nlm.nih.gov/pubmed/37817928 http://dx.doi.org/10.1097/GOX.0000000000005326 |
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author | Dunson, Blake Kogan, Samuel Grosser, Joshua A. Davidson, Amelia Llull, Ramon |
author_facet | Dunson, Blake Kogan, Samuel Grosser, Joshua A. Davidson, Amelia Llull, Ramon |
author_sort | Dunson, Blake |
collection | PubMed |
description | BACKGROUND: Closed-incision negative pressure wound therapy (ciNPWT) has shown promise in reducing surgical wound complications. Among its numerous benefits, it allows for exudate management and tension offloading from wound edges. The purpose of this systematic review and meta-analysis was to assess the efficacy of prophylactic ciNPWT versus conventional dressings on abdominal donor site complications in microsurgical breast reconstruction (MR). METHODS: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in January 2023. PubMed and Embase were searched to identify all relevant studies. Data collected included rates of total wound complications, wound dehiscence, infection, seroma, and length of hospital stay. RESULTS: A total of 202 articles were screened, and eight studies (1009 patients) met the inclusion criteria. Use of ciNPWT was associated with a significantly lower rate of wound dehiscence (OR, 0.53; 95% confidence interval, 0.33–0.85; P = 0.0085, I(2) = 0%). There was no significant difference in the rate of total wound complications [odds ratio (OR), 0.63; 95% CI, 0.35–1.14; P = 0.12, I(2) = 69%], donor site infection (OR, 0.91; 95% CI, 0.42–1.50; P = 0.47, I(2) = 13%), seroma (OR, 0.74; 95% CI, 0.22–2.49; P = 0.63, I(2) = 57%), or length of hospital stay (SMD, 0.089; 95% CI, –0.13–0.35; P = 0.37, I(2) = 29%). CONCLUSIONS: Although exudate management by ciNPWT fails to reduce surgical site infection, seroma formation, and overall length of stay, ciNPWT tension offloading properties seem to be associated with lower rates of wound dehiscence when compared with conventional dressings in abdominal-based autologous breast reconstruction. |
format | Online Article Text |
id | pubmed-10561809 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-105618092023-10-10 Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction Dunson, Blake Kogan, Samuel Grosser, Joshua A. Davidson, Amelia Llull, Ramon Plast Reconstr Surg Glob Open Breast BACKGROUND: Closed-incision negative pressure wound therapy (ciNPWT) has shown promise in reducing surgical wound complications. Among its numerous benefits, it allows for exudate management and tension offloading from wound edges. The purpose of this systematic review and meta-analysis was to assess the efficacy of prophylactic ciNPWT versus conventional dressings on abdominal donor site complications in microsurgical breast reconstruction (MR). METHODS: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in January 2023. PubMed and Embase were searched to identify all relevant studies. Data collected included rates of total wound complications, wound dehiscence, infection, seroma, and length of hospital stay. RESULTS: A total of 202 articles were screened, and eight studies (1009 patients) met the inclusion criteria. Use of ciNPWT was associated with a significantly lower rate of wound dehiscence (OR, 0.53; 95% confidence interval, 0.33–0.85; P = 0.0085, I(2) = 0%). There was no significant difference in the rate of total wound complications [odds ratio (OR), 0.63; 95% CI, 0.35–1.14; P = 0.12, I(2) = 69%], donor site infection (OR, 0.91; 95% CI, 0.42–1.50; P = 0.47, I(2) = 13%), seroma (OR, 0.74; 95% CI, 0.22–2.49; P = 0.63, I(2) = 57%), or length of hospital stay (SMD, 0.089; 95% CI, –0.13–0.35; P = 0.37, I(2) = 29%). CONCLUSIONS: Although exudate management by ciNPWT fails to reduce surgical site infection, seroma formation, and overall length of stay, ciNPWT tension offloading properties seem to be associated with lower rates of wound dehiscence when compared with conventional dressings in abdominal-based autologous breast reconstruction. Lippincott Williams & Wilkins 2023-10-09 /pmc/articles/PMC10561809/ /pubmed/37817928 http://dx.doi.org/10.1097/GOX.0000000000005326 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/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) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , 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. |
spellingShingle | Breast Dunson, Blake Kogan, Samuel Grosser, Joshua A. Davidson, Amelia Llull, Ramon Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction |
title | Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction |
title_full | Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction |
title_fullStr | Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction |
title_full_unstemmed | Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction |
title_short | Influence of Closed-incision Negative Pressure Wound Therapy on Abdominal Site Complications in Autologous Breast Reconstruction |
title_sort | influence of closed-incision negative pressure wound therapy on abdominal site complications in autologous breast reconstruction |
topic | Breast |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561809/ https://www.ncbi.nlm.nih.gov/pubmed/37817928 http://dx.doi.org/10.1097/GOX.0000000000005326 |
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