The effect of postoperative closed incision negative pressure therapy on the incidence of donor site wound dehiscence in breast reconstruction patients: DEhiscence PREvention Study (DEPRES), pilot randomized controlled trial.

Autor: Muller-Sloof E; Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Emmy.Muller-Sloof@radboudumc.nl., de Laat HEW; Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Erik.delaat@radboudumc.nl., Hummelink SLM; Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Stefan.Hummelink@radboudumc.nl., Peters JWB; HAN University Applied Sciences, Department Master Advanced Nursing Practice, Groenewoudseweg 1, 6524 TM, Nijmegen, The Netherlands. Electronic address: Jeroen.Peters@han.nl., Ulrich DJO; Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, P/O Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Dietmar.Ulrich@radboudumc.nl.
Jazyk: angličtina
Zdroj: Journal of tissue viability [J Tissue Viability] 2018 Nov; Vol. 27 (4), pp. 262-266. Date of Electronic Publication: 2018 Aug 14.
DOI: 10.1016/j.jtv.2018.08.005
Abstrakt: Aim: Wound dehiscence is a serious postoperative complication associated both with high morbidity and mortality. It has a significant rate of occurrence in breast reconstruction surgeries with a deep internal epigastric perforator (DIEP) and with a profunda artery perforator (PAP) flap. Risk factors for wound dehiscence include smoking, diabetes mellitus, chronic obstructive pulmonary disease, and obesity. The aim of this pilot study was to assess whether postoperative treatment with closed incision negative pressure therapy (ciNPT) decreases the incidence of donor site wound dehiscence in breast reconstruction patients.
Method: Women undergoing a breast reconstruction with a DIEP or PAP flap were enrolled in a pilot randomized controlled trial and assigned treatment with either ciNPT or adhesive strips. The primary outcome was wound dehiscence upon follow-up after four weeks. Secondary outcomes that were evaluated included wound infection, pain, and allergy. There was no loss to follow-up.
Results: This pilot study included 51 women (n = 25 ciNPT, n = 26 adhesive strips). The two groups did not differ significantly in patients demographics or comorbidities. Wound dehiscence occurred in 11 patients (n = 2 ciNPT, n = 9 adhesive strips). This difference was statistically significant: p = 0.038. There were no statistically significant differences in secondary outcomes between the two groups.
Conclusion: In this pilot study, postoperative treatment with ciNPT decreased the incidence of donor site wound dehiscence in breast reconstruction patients. Further research is ongoing by the same hospital. This trial was registered in the Netherlands Trial Register (NTR) under ID no. NTR5808.
(Copyright © 2018 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: