The Role of Incisional Negative Pressure Wound Therapy in Improving the Outcome of Reduction Mammoplasty, An Egyptian Experience

Abstract

Introduction: "T" junction dehiscence puts a burden on the reputation of breast reduction. A lot of methods have been described to solve this issue but still have their limitations. iNPWT is being popularized in different specialties as a preventive solution to problematic incisions (e.g. knee and hip replacements). It helps prevention of wound complications through reduction of edema decreasing tension on wound edges and increasing vascularity. iNPWT has always been advocated not only to help wound healing but it is also suggested it produces a better scar on the long term.Patients and Methods: Twenty patients presenting seeking breast reduction were included in this study. The Bilateral nature of the breast allowed for the patient to be her own control with randomization of treatment modalities per side. iNPWT was used on one side while on the other side conventional dressing was used. The rate of wound healing complication as well as quality of the scar (using the Manchester score), were the main pillars of this study.Results: This study showed that the incidence of dehiscence in iNPWT group was 35%, while it was 45% in the standard dressing. Though we felt there are numerical and clinical superiority in the incidence and even the depth of dehiscence between iNPWT & traditional dressing, there was no statically significance to support this observation. The Manchester scar score showed a significant higher number in the standard care group with a p-value of (p=0.0114). Conclusion:iNPWT offers an alternative preventative measure for "T" junction problems in Wise pattern reduction mammoplasty. Though it was not statistically significant we still believe that it showed superior results. iNPWT showed improvement in the quality of the scar. Further national studies about its cost effectiveness in developing countries are recommended as well as its uses in other fields of plastic surgery.