Does the Use of Incisional Negative-Pressure Wound Therapy Prevent Mastectomy Flap Necrosis in Immediate Expander-Based Breast Reconstruction?

Kim, Dae Young; Park, Sun-June; Bang, Sa Ik; Mun, Goo‐Hyun; Pyon, Jai‐Kyong

doi:10.1097/prs.0000000000002431

Cited by 43 publications

(55 citation statements)

References 39 publications

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“…The overall rate of skin flap necrosis after mastectomy with reconstruction was 24.6% (30/122). This rate is higher than that found in other studies, but given the fact that DTI reconstruction is associated with a high skin flap necrosis rate, this result is consistent with previous results [2,3,8,25]. The rate of severe skin flap necrosis was 4.1% (5/122) in the entire patient population, which is also consistent with other study results [2].…”

Section: Discussionsupporting

confidence: 92%

“…Implant-associated infections can result in prolonged antibiotic use, additional surgical treatment, and implant removal [7]. Therefore, the application of an NPWT device as a preventive or treatment option for mastectomy flap necrosis has been examined [8]. The results of these studies suggest that the use of such a device is an effective treatment strategy.…”

mentioning

confidence: 99%

“…Studies have examined the effects of NPWT device usage in patients who undergo breast reconstruction [8,9]. However, prior NPWT devices are large and heavy, and the noise from the large motor interferes with everyday activities and makes it difficult to maintain the device on an outpatient basis [10].…”

mentioning

confidence: 99%

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A single-use negative-pressure wound therapy device can reduce mastectomy skin flap necrosis in direct-to-implant breast reconstruction

Kim

et al. 2020

Arch Aesthetic Plast Surg

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A single-use negative-pressure wound therapy device can reduce mastectomy skin flap necrosis in direct-toimplant breast reconstruction INTRODUCTION Mastectomy skin flap necrosis is a challenging complication that makes wound management more difficult in patients who undergo breast reconstruction. Overall, the reported incidence of skin flap necrosis ranges from 1.5% to 41.2% of breast reconstruction cases [1]. A higher body mass index (BMI), use of immediate breast reconstruction, use of a nipple-sparing mastectomy, a history of smoking, hypertension, diabetes, or exposure to preoperative radiation, or some combination of these factors are correlated with an increased risk of skin flap necrosis [2]. Mastectomy skin flap necrosis requires wound treatment that

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

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A single-use negative-pressure wound therapy device can reduce mastectomy skin flap necrosis in direct-to-implant breast reconstruction

Kim

et al. 2020

Arch Aesthetic Plast Surg

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“…The incisional NPWT group had a lower overall complication rate, overall mastectomy f lap necrosis rate, and major mastectomy f lap necrosis than the conventional dressing group [59].…”

Section: Breast Surgerymentioning

confidence: 81%

Application of Negative Pressure Wound Therapy on Closed Incisions

Joshi¹,

Hsieh²,

Hassan³

et al. 2020

Wound Healing

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Negative pressure wound therapy (NPWT) is widely used for chronic and acute open wounds, with clinically proven benefits of faster wound healing by promoting granulation tissue growth and increased perfusion and facilitating epithelialization and contraction. Improved outcomes on open wounds prompted the application of NPWT on closed surgical incisions. The application of NPWT, in the immediate postoperative period, reduces surgical site infections (SSIs) and wound dehiscence by 50% in high-risk patients. The negative pressure reduces wound edema and improves local perfusion and lymphatic f low, thereby minimizing hematoma and seroma rates. The improved perfusion and oxygenation facilitate quicker wound healing as well as minimize ischemic complications like f lap necrosis. Recent literature supports enhanced wound healing and superior scar appearance as well as improved wound maturity, evidenced by 50% more force required to pull apart a sutured incision. Improved outcomes of incisional NPWT are reported from various surgical procedures on abdominal, breast, orthopedic, vascular, cardiac, and plastic surgeries. Further clinical studies and cost-benefit analysis are needed to recommend routine postoperative use of incisional NPWT in high-risk and low-risk patient population.

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“…10,11,13 Clinical studies have shown that incisional NPWT can help to reduce the complication rates in contaminated surgeries (sternal incisions and laparotomy incisions), surgeries involving artificial implants underneath the incision (hernia repair, vascular surgery, joint surgery), [28][29][30] and arthroplasty procedures. 31,32 Recently, incisional NPWT use on mastectomy flaps has reduced their necrosis rate in patients undergoing immediate implant-based breast reconstruction. 33 Higher on the reconstructive ladder, NPWT has shown great value when employed in skin grafting.…”

Section: Discussionmentioning

confidence: 99%

Use of Incisional Negative Pressure Wound Therapy in Skin-Containing Free Tissue Transfer

Khan

et al. 2017

J reconstr Microsurg

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Does the Use of Incisional Negative-Pressure Wound Therapy Prevent Mastectomy Flap Necrosis in Immediate Expander-Based Breast Reconstruction?

Abstract: Therapeutic, III.

Cited by 43 publications

References 39 publications

A single-use negative-pressure wound therapy device can reduce mastectomy skin flap necrosis in direct-to-implant breast reconstruction

A single-use negative-pressure wound therapy device can reduce mastectomy skin flap necrosis in direct-to-implant breast reconstruction

Application of Negative Pressure Wound Therapy on Closed Incisions

Use of Incisional Negative Pressure Wound Therapy in Skin-Containing Free Tissue Transfer

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