Negative Pressure Wound Therapy Reduces Wound Breakdown and Implant Loss in Prepectoral Breast Reconstruction
| Autor: | George Boundouki, John A. Murphy, Dave Myers, Bilal Fakim, Gareth Irwin, Richard Johnson, Richard Searle, Lyndsey Highton |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
integumentary system business.industry Patient demographics medicine.medical_treatment Wound Breakdown 030230 surgery Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Negative-pressure wound therapy medicine Implant reconstruction Original Article Implant Single institution Breast reconstruction Prospective cohort study business |
| Zdroj: | Plastic and Reconstructive Surgery Global Open |
| ISSN: | 2169-7574 |
| Popis: | Background Single-use negative pressure wound therapy (NPWT) has been shown to encourage wound healing. It is often used when patient factors impair wound healing, or in more complex wounds, such as in implant-based breast reconstruction. We report the findings of a prospective cohort study comparing the use of NPWT with standard dressings in prepectoral breast reconstruction. Methods A prospective database of implant-based reconstruction from a single institution was mined to identify patients who underwent prepectoral reconstruction. Patient demographics, operative data, surgical complications, and 90-day outcomes were compared between patients who had NPWT and those who had standard dressings. Results Prepectoral implant-based breast reconstruction was performed on 307 breasts. NPWT dressings were used in 126 cases, with standard dressings used in 181 cases. Wound breakdown occurred in 10 cases after standard dressings versus 1 where NPWT was utilized. Of the standard dressing cases, only 3 implants were salvaged, while 7 cases led to implant loss. The 1 case of wound breakdown in the NPWT cohort settled with conservative measures. The cost of a reconstructive failure was £14,902, and the use of NPWT resulted in a cost savings of £426 per patient. Conclusions The utilization of single-use NPWT reduces the rate of wound breakdown and implant loss in prepectoral implant-based reconstruction. In addition to the significant clinical benefits, this approach is cost-saving compared with standard dressings. These data suggest that prepectoral implant reconstruction should be considered as an indication for the use of NPWT. |
| Databáze: | OpenAIRE |
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