A novel negative pressure wound therapy (NPWT) monitoring system for postoperative flap management

Abstract

Various types of flaps are widely utilized as reconstructive options for patients with soft tissue defects. However, the postoperative monitoring of the flap requires a large amount of time and effort. The aim of this study was to evaluate the efficacy and safety of this novel monitoring procedure using negative pressure wound therapy (NPWT) immediately after the flap operations.A retrospective analysis was performed on patients who underwent free flaps and perforator flaps from March 2019 to December 2020. The flaps were managed by either novel NPWT method or conventional dressing. Among NPWT group, computed tomography angiography was performed in randomly selected 5 flaps on the third postoperative day for evaluation of pedicle compression. Statistical analysis was performed between the 2 groups.A total of 54 flaps were included in this study. Twenty seven flaps were managed using novel NPWT method and 27 flaps were managed using conventional dressing. There was no statistically significant difference in flap survival rates between the 2 groups (P = .91). The patency of flap pedicles in the NPWT group was confirmed by comparing the computed tomography angiography findings. The estimated total flap monitoring time and cost for 5 days was significantly decreased by the application of the novel NPWT monitoring system.Through the application of the novel postoperative monitoring system using NPWT, there is efficient evaluation of the flap. Furthermore, safe flap monitoring is possible with the reduced risk of infection by the avoidance of multiple manual dressing performed in the conventional method.

Negative Pressure Wound Therapy (NPWT) after Hybrid Reconstruction of Occipital Pressure Sore Using Local Flap and Skin Graft

“…Although the same flap survival rate (100%) was observed in the NPWT and conventional dressing groups in our study, NPWT resolves venous congestion of flap surgery by promoting local circulation and facilitating revascularization through neoangiogenesis, which is especially beneficial given that venous congestion is a common cause of flap failure [ 26 , 27 ]. In addition, an advantage of postoperative flap monitoring using NPWT is the prevention of infection-associated complications [ 28 ]. A few studies have reported adverse effects of NPWT.…”

“…Furthermore, pressure sore patients are usually at high risk of surgical site infection and developing another pressure sore [ 33 ]. NPWT can be a good tool for preventing surgical site infection or pressure sores [ 28 ]. In addition, the reason we prefer skin graft instead of using multiple local flaps is that in most patients with unconscious or position limitation, reducing the operative area can prevent complications such as flap failure.…”