First Experiences with Incisional Negative Pressure Wound Therapy in a High-Risk Poststernotomy Patient Population treated with Pectoralis Major Muscle Flap for Deep Sternal Wound Infection

Abstract

The application of Prevena significantly reduced revision surgery rates in obese patients treated with unilateral pectoralis major flap for deep sternal wound infections.

Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction

“…The reduction in overall complications and hospital stay are directly related to each other and both have been reported before. 13,15,17,18,27 Our results vary from some earlier reports 14,15,20 where a reduction in the number of complications requiring surgery was reported. Our study did not find this during the initial stay in hospital, but we found a reduction in open wounds at 3 months after surgery, which indirectly resulted in a reduction for the need of later surgical revisions.…”

“…31 Incisional negative pressure therapy for closed wounds has shown to be beneficial in several surgical subgroups. [12][13][14][15][17][18][19][20][22][23][24][25][26][27] It has not, however, been reported before in the treatment after pressure ulcer reconstructions. The current study aimed to see whether there was a difference in rates of acute and late wound-healing complications or other outcome measures when the postoperative dressing was switched from a regular wound dressing to an incisional negative pressure wound dressing in this very specific group of challenging patients.…”

“…Incisional negative pressure therapy for closed wounds has shown to be beneficial in several surgical subgroups . It has not, however, been reported before in the treatment after pressure ulcer reconstructions.…”

“…iNPWT has been used to improve wound‐healing outcomes in sutured wounds in various surgical specialties and procedures, including caesarean sections, vascular surgery, loop ileostomy reversal, cardiac surgery, open vein harvest in cardiac surgery, sternotomy, pectoralis major muscle flap for deep sternal infections, incisional ventral hernia repairs, orthopaedic surgery for acetabular fractures, knee arthroplasties, hip arthroplasties, femoral neck fractures, immediate breast reconstructions, and post‐bariatric abdominoplasties . These studies found that the use of incisional negative pressure therapy immediately after surgery decreased the number of SSIs, overall wound complications, seroma formation, and complications requiring repeat surgery . Also noted were reduced length of stay in hospital and in intensive care unit, reduced wound drainage, and time needed for dressing changes .…”

“…27 These studies found that the use of incisional negative pressure therapy immediately after surgery decreased the number of SSIs, 12,13,16,17,19 overall wound complications, 13,15,17,27 seroma formation, 24,25 and complications requiring repeat surgery. 14,15,20 Also noted were reduced length of stay in hospital 18,27 and in intensive care unit, 20 reduced wound drainage, 21,[24][25][26] and time needed for dressing changes. 25,27 Finally, shortened time for drain removal 26 and increased ability to self-care 18 have also been identified.…”