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The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes

BACKGROUND: Studies report that incision management with closed incision negative pressure therapy (ciNPT) may provide clinical benefits, including protecting surgical incisions, for postsurgical closed incisions (eg, orthopedic, sternotomy, and colorectal). This retrospective analysis compared post...

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Autores principales: Gabriel, Allen, Sigalove, Steven, Sigalove, Noemi, Storm-Dickerson, Toni, Rice, Jami, Maxwell, Patrick, Griffin, Leah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181498/
https://www.ncbi.nlm.nih.gov/pubmed/30324063
http://dx.doi.org/10.1097/GOX.0000000000001880
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author Gabriel, Allen
Sigalove, Steven
Sigalove, Noemi
Storm-Dickerson, Toni
Rice, Jami
Maxwell, Patrick
Griffin, Leah
author_facet Gabriel, Allen
Sigalove, Steven
Sigalove, Noemi
Storm-Dickerson, Toni
Rice, Jami
Maxwell, Patrick
Griffin, Leah
author_sort Gabriel, Allen
collection PubMed
description BACKGROUND: Studies report that incision management with closed incision negative pressure therapy (ciNPT) may provide clinical benefits, including protecting surgical incisions, for postsurgical closed incisions (eg, orthopedic, sternotomy, and colorectal). This retrospective analysis compared postoperative outcomes in patients who received ciNPT versus standard of care (SOC) for incision management after breast reconstruction postmastectomy. METHODS: Patient demographics, chemotherapy exposure, surgical technique, ciNPT use, number of drains, time to drain removal, and 90-day postoperative complication rates were analyzed from records of 356 patients (ciNPT = 177, SOC = 179) with 665 closed breast incisions (ciNPT = 331, SOC = 334). RESULTS: Overall complication rate was 8.5% (28/331) in ciNPT group compared with 15.9% (53/334) in SOC group (P = 0.0092). Compared with the SOC group, the ciNPT group had significantly lower infection rates [7/331 (2.1%) versus 15/334 (4.5%), respectively; P = 0.0225], dehiscence rates [8/331 (2.4%) versus 18/334 (5.4%), respectively; P = 0.0178], necrosis rates [17/331 (5.1%) versus 31/334 (9.3%), respectively; P = 0.0070], and seroma rates [6/331 (1.8%) versus 19/334 (5.7%), respectively; P = 0.0106]. The ciNPT group required significantly fewer returns to operating room compared with the SOC group [8/331 (2.4%) versus 18/334 (5.4%), respectively; P = 0.0496]. Time to complete drain removal per breast for ciNPT versus SOC groups was 9.9 versus 13.1 days (P < 0.0001), respectively. CONCLUSIONS: Patients who received ciNPT over closed incisions following postmastectomy breast reconstruction experienced a shorter time to drain removal and significantly lower rates of infection, dehiscence, necrosis, and seromas, compared with the SOC group. Randomized controlled studies are needed to corroborate the findings in our study.
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spelling pubmed-61814982018-10-15 The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes Gabriel, Allen Sigalove, Steven Sigalove, Noemi Storm-Dickerson, Toni Rice, Jami Maxwell, Patrick Griffin, Leah Plast Reconstr Surg Glob Open Original Article BACKGROUND: Studies report that incision management with closed incision negative pressure therapy (ciNPT) may provide clinical benefits, including protecting surgical incisions, for postsurgical closed incisions (eg, orthopedic, sternotomy, and colorectal). This retrospective analysis compared postoperative outcomes in patients who received ciNPT versus standard of care (SOC) for incision management after breast reconstruction postmastectomy. METHODS: Patient demographics, chemotherapy exposure, surgical technique, ciNPT use, number of drains, time to drain removal, and 90-day postoperative complication rates were analyzed from records of 356 patients (ciNPT = 177, SOC = 179) with 665 closed breast incisions (ciNPT = 331, SOC = 334). RESULTS: Overall complication rate was 8.5% (28/331) in ciNPT group compared with 15.9% (53/334) in SOC group (P = 0.0092). Compared with the SOC group, the ciNPT group had significantly lower infection rates [7/331 (2.1%) versus 15/334 (4.5%), respectively; P = 0.0225], dehiscence rates [8/331 (2.4%) versus 18/334 (5.4%), respectively; P = 0.0178], necrosis rates [17/331 (5.1%) versus 31/334 (9.3%), respectively; P = 0.0070], and seroma rates [6/331 (1.8%) versus 19/334 (5.7%), respectively; P = 0.0106]. The ciNPT group required significantly fewer returns to operating room compared with the SOC group [8/331 (2.4%) versus 18/334 (5.4%), respectively; P = 0.0496]. Time to complete drain removal per breast for ciNPT versus SOC groups was 9.9 versus 13.1 days (P < 0.0001), respectively. CONCLUSIONS: Patients who received ciNPT over closed incisions following postmastectomy breast reconstruction experienced a shorter time to drain removal and significantly lower rates of infection, dehiscence, necrosis, and seromas, compared with the SOC group. Randomized controlled studies are needed to corroborate the findings in our study. Wolters Kluwer Health 2018-08-07 /pmc/articles/PMC6181498/ /pubmed/30324063 http://dx.doi.org/10.1097/GOX.0000000000001880 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 Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Gabriel, Allen
Sigalove, Steven
Sigalove, Noemi
Storm-Dickerson, Toni
Rice, Jami
Maxwell, Patrick
Griffin, Leah
The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes
title The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes
title_full The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes
title_fullStr The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes
title_full_unstemmed The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes
title_short The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes
title_sort impact of closed incision negative pressure therapy on postoperative breast reconstruction outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181498/
https://www.ncbi.nlm.nih.gov/pubmed/30324063
http://dx.doi.org/10.1097/GOX.0000000000001880
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