Negative pressure wound therapy does not decrease postoperative wound complications in patients undergoing mastectomy and flap fixation

Abstract

Patients and breast cancer surgeons are frequently confronted with wound complications after mastectomy. Negative pressure wound therapy (NPWT) is a promising technique for preventing wound complications after skin closure in elective surgery. However, a clinical study evaluating postoperative complications following the use of NPWT, focusing solely on closed incisions in patients undergoing mastectomy, has yet to be performed. Between June 2019 and February 2020, 50 consecutive patients underwent mastectomy with NPWT during the first seven postoperative days. This group was compared to a cohort of patients taking part in a randomized controlled trial between June 2014 and July 2018. Primary outcome was the rate of postoperative wound complications, i.e. surgical site infections, wound necrosis or wound dehiscence during the first three postoperative months. Secondary outcomes were the number of patients requiring unplanned visits to the hospital and developing clinically significant seroma (CSS). In total, 161 patients were analyzed, of whom 111 patients in the control group (CON) and 50 patients in the NPWT group (NPWT). Twenty-eight percent of the patients in the NPWT group developed postoperative wound complications, compared to 18.9% in the control group (OR = 1.67 (95% CI 0.77–3.63), p = 0.199). The number of patients requiring unplanned visits or developing CSS was not statistically significant between the groups. This study suggests that Avelle negative pressure wound therapy in mastectomy wounds does not lead to fewer postoperative wound complications. Additionally, it does not lead to fewer patients requiring unplanned visits or fewer patients developing clinically significant seromas.Trial registration: ClinicalTrials.gov number, NCT03942575. Date of registration: 08/05/2019.

Effectiveness of prophylactic application of negative pressure wound therapy in stopping surgical site wound problems for closed incisions in breast cancer surgery: A meta‐analysis

“…A total of 1765 relevant studies were screened, of which 12 studies between 2014 and 2022, met the inclusion criteria, and were involved in the meta‐analysis. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 Data obtained from these studies were shown in Table 2 .…”

“…The current meta‐analysis involved 2223 women with closed incisions in breast cancer surgery at the baseline of the studies; 964 of them were using the prophylactic application of negative pressure wound therapy, and 1259 were using standard dressings 18‐29 . With The prophylactic application of negative pressure wound therapy women had a significantly lower total wound problem, lower surgical site wound infection, lower wound dehiscence, and lower wound necrosis, in women with closed incisions in breast cancer surgery compared with standard dressings.…”

“…The current meta-analysis involved 2223 women with closed incisions in breast cancer surgery at the baseline of the studies; 964 of them were using the prophylactic application of negative pressure wound therapy, and 1259 were using standard dressings. [18][19][20][21][22][23][24][25][26][27][28][29] With The prophylactic application of negative pressure wound therapy women had a significantly lower total wound problem, lower surgical site wound infection, lower wound dehiscence, and lower wound necrosis, in women with closed incisions in breast cancer surgery compared with standard dressings. However, prophylactic application of negative pressure wound therapy did not show any significant difference in wound seroma, and hematoma compared with standard dressings in women with closed incisions in breast cancer surgery.…”

Effect of Vacuum Sealing Drainage on Soft Tissue Injury of Traumatic Fracture and Its Effect on Wound Recovery

“…VSD renders benefits to various types of surgeries. In breast surgery with easy recurrence and multiple complications, for example, the use of VSD can reduce seroma and its sequelae [22,23]. As an auxiliary treatment method for open wounds, VSD will apply controllable negative pressure to the wounds through various equipment and professional dressings, and transfer wound liquid to appropriate containers, which can create a wound environment conducive to healing by removing infected materials and exudates, reducing edema, and Evidence-Based Complementary and Alternative Medicine promoting perfusion and granulation [24,25].…”

Emerging treatment strategies in wound care

“…127,128 The NPWT controls the exudate by fluid removal and thus prevents infection and cross-contamination (Figure 4). 129 This method also reduces edema, stimulates angiogenesis, helps to maintain wound moisture, and finally promotes contraction of the wound edges. This technique has been used for the treatment of acute and chronic wounds, open wounds, burns, diabetic wounds and also venous and arterial wounds.…”