Utilizing NPWT improving skin graft taking in reconstruction for extended breast skin defects following mastectomy

Kuo, Chang‐Fu; Kan, Jung‐Yu; Kao, Chieh-Ni; Ouyang, Fusheng; Wu, Cheng-Che; Shiau, Jun‐Ping; Li, Chung-Liang; Hou, Ming‐Feng; Huang, Shu-Hung

doi:10.1002/ccr3.4716

Cited by 2 publications

(1 citation statement)

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“…Closed-incision negative wound therapy represents as reliable tools to reduce surgical site complications on the abdominal donor-site in autologous free-flap breast reconstruction[ 22 ]. Kuo et al [ 23 ] presented successful cases of latissimus dorsi muscle flap and skin graft reconstruction with NPWT to large breast wounds. Complete resection of necrotic tissue preceded the application of NPWT, and most of the necrotic tissue resolved within five days according to previous research[ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Devastating complication of negative pressure wound therapy after deep inferior epigastric perforator free flap surgery: A case report

Lim¹,

Lee²,

Kim³

et al. 2023

World J Clin Cases

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BACKGROUND Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence. They require immediate and appropriate management before they progress to an irreversible condition. Although negative pressure wound therapy (NPWT) can prevent wound progression by increasing microcirculation, the inappropriate application of NPWT on complication-threatened transferred and replanted tissues can induce an adverse effect. CASE SUMMARY A 48-year-old woman who underwent immediate breast reconstruction with a deep inferior epigastric artery perforator free flap. While applying a heating pad directly to the flap site, she sustained a deep second to third-degree contact burn over 30% of the transferred flap on postoperative 7 d. As the necrotic changes had progressed, we applied an NPWT dressing over the burned area after en-bloc debridement of the transferred tissues on postoperative 21 d. After 4 d of NPWT application, the exposed fatty tissues of the flap changed to dry and brown-colored necrotic tissues. Upon further debridement, we noted that the wound gradually reached total necrosis with a collapsed vascular pedicle of deep inferior epigastric artery. CONCLUSION Although NPWT has been shown to be successful for treating various wound types, the significant risk of NPWT application in short-lasting reconstructed flap wounds after thermal injury should be reminded.

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Section: Discussionmentioning

confidence: 99%