Cargando…

Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty

BACKGROUND: It has been proposed that negative pressure wound therapy (NPWT) applied prophylactically to a closed incision may decrease the incidence of wound complications. Patients undergoing reduction mammaplasty are at risk of wound complications such as delayed healing, infection, and dehiscenc...

Descripción completa

Detalles Bibliográficos
Autores principales: Galiano, Robert D., Hudson, Donald, Shin, Joseph, van der Hulst, René, Tanaydin, Volkan, Djohan, Risal, Duteille, Franck, Cockwill, John, Megginson, Sarah, Huddleston, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811280/
https://www.ncbi.nlm.nih.gov/pubmed/29464150
http://dx.doi.org/10.1097/GOX.0000000000001560
_version_ 1783299843633971200
author Galiano, Robert D.
Hudson, Donald
Shin, Joseph
van der Hulst, René
Tanaydin, Volkan
Djohan, Risal
Duteille, Franck
Cockwill, John
Megginson, Sarah
Huddleston, Elizabeth
author_facet Galiano, Robert D.
Hudson, Donald
Shin, Joseph
van der Hulst, René
Tanaydin, Volkan
Djohan, Risal
Duteille, Franck
Cockwill, John
Megginson, Sarah
Huddleston, Elizabeth
author_sort Galiano, Robert D.
collection PubMed
description BACKGROUND: It has been proposed that negative pressure wound therapy (NPWT) applied prophylactically to a closed incision may decrease the incidence of wound complications. Patients undergoing reduction mammaplasty are at risk of wound complications such as delayed healing, infection, and dehiscence, and the bilateral nature of the surgery allows for a within-patient randomized study to evaluate incisional NPWT’s effect in reducing healing complications. METHODS: In this multicenter trial, 200 patients undergoing bilateral reduction mammaplasty were treated with PICO Single-Use NPWT System or standard wound-care dressings randomized to right or left breast for up to 14 days to enable within-patient comparison. Follow-up assessments were conducted to evaluate the difference in incision healing complications up to 21 days postsurgery. Healing complications (for the primary endpoint) were defined as delayed healing (incision not 100% closed by 7 days) and occurrence of dehiscence or infection within 21 days. Individual healing complications were assessed separately as secondary endpoints. RESULTS: Significantly fewer healing complications (primary endpoint) were noted in NPWT-treated breasts [113 (56.8%)] versus standard care [123 (61.8%)]. The difference of 10 (5.0%) patients with fewer healing complications using NPWT was statistically significant (P = 0.004). NPWT also resulted in a significantly lower incidence of dehiscence (secondary endpoint) compared with standard care [32 patients (16.2%) versus 52 patients (26.4%)] by day 21, a relative reduction of 38% (P < 0.001). CONCLUSIONS: This is the first major prospective, within-patient, randomized, controlled, multicenter study to provide evidence for an incisional NPWT strategy to reduce healing complications.
format Online
Article
Text
id pubmed-5811280
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-58112802018-02-20 Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty Galiano, Robert D. Hudson, Donald Shin, Joseph van der Hulst, René Tanaydin, Volkan Djohan, Risal Duteille, Franck Cockwill, John Megginson, Sarah Huddleston, Elizabeth Plast Reconstr Surg Glob Open Original Article BACKGROUND: It has been proposed that negative pressure wound therapy (NPWT) applied prophylactically to a closed incision may decrease the incidence of wound complications. Patients undergoing reduction mammaplasty are at risk of wound complications such as delayed healing, infection, and dehiscence, and the bilateral nature of the surgery allows for a within-patient randomized study to evaluate incisional NPWT’s effect in reducing healing complications. METHODS: In this multicenter trial, 200 patients undergoing bilateral reduction mammaplasty were treated with PICO Single-Use NPWT System or standard wound-care dressings randomized to right or left breast for up to 14 days to enable within-patient comparison. Follow-up assessments were conducted to evaluate the difference in incision healing complications up to 21 days postsurgery. Healing complications (for the primary endpoint) were defined as delayed healing (incision not 100% closed by 7 days) and occurrence of dehiscence or infection within 21 days. Individual healing complications were assessed separately as secondary endpoints. RESULTS: Significantly fewer healing complications (primary endpoint) were noted in NPWT-treated breasts [113 (56.8%)] versus standard care [123 (61.8%)]. The difference of 10 (5.0%) patients with fewer healing complications using NPWT was statistically significant (P = 0.004). NPWT also resulted in a significantly lower incidence of dehiscence (secondary endpoint) compared with standard care [32 patients (16.2%) versus 52 patients (26.4%)] by day 21, a relative reduction of 38% (P < 0.001). CONCLUSIONS: This is the first major prospective, within-patient, randomized, controlled, multicenter study to provide evidence for an incisional NPWT strategy to reduce healing complications. Wolters Kluwer Health 2018-01-12 /pmc/articles/PMC5811280/ /pubmed/29464150 http://dx.doi.org/10.1097/GOX.0000000000001560 Text en Copyright © 2018 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) (http://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 Original Article
Galiano, Robert D.
Hudson, Donald
Shin, Joseph
van der Hulst, René
Tanaydin, Volkan
Djohan, Risal
Duteille, Franck
Cockwill, John
Megginson, Sarah
Huddleston, Elizabeth
Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty
title Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty
title_full Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty
title_fullStr Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty
title_full_unstemmed Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty
title_short Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty
title_sort incisional negative pressure wound therapy for prevention of wound healing complications following reduction mammaplasty
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811280/
https://www.ncbi.nlm.nih.gov/pubmed/29464150
http://dx.doi.org/10.1097/GOX.0000000000001560
work_keys_str_mv AT galianorobertd incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT hudsondonald incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT shinjoseph incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT vanderhulstrene incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT tanaydinvolkan incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT djohanrisal incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT duteillefranck incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT cockwilljohn incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT megginsonsarah incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty
AT huddlestonelizabeth incisionalnegativepressurewoundtherapyforpreventionofwoundhealingcomplicationsfollowingreductionmammaplasty