Efficacy of Closed Incision Negative Pressure Wound Therapy on Abdominal Donor Site After Free Flap Breast Reconstruction

Andres F. Doval, MD; Vishwanath Chegireddy, MD; Lauren Beal, BA; Christian Arroyo-Alonso, MD; Dmitry Zavlin, MD; Aldona J. Spiegel, MD; Warren A. Ellsworth, MD

Disclosures

Wounds. 2021;33(4):81-85. 

In This Article

Methods

After institutional review board approval was obtained from Houston Methodist Hospital in Houston, Texas, a retrospective cohort study was conducted and included all patients who underwent abdominally based microsurgical breast reconstruction from December 2016 to February 2018. All cases were performed by the senior authors of this study.

For each patient, relevant demographic information, comorbidities, perioperative variables, and postoperative donor site complications were reviewed and recorded.

Abdominal donor site complications included in the analysis were as follows: wound dehiscence, seroma (requiring drain placement or surgical drainage), infection (defined as abscess that required surgical intervention or cellulitis that required intravenous antibiotics), abdominal bulge, and abdominal hernia (clinically diagnosed).

Importantly, the abdominal wound is closed in 3 layers: (1) Scarpa's facia is closed using polydioxanone sutures (PDS II; Ethicon), (2) interrupted poliglecaprone 25 undyed monofilament suture (3-0 Monocryl; Ethicon) in the dermis, and (3) then running buried 3-0 poliglecaprone 25 undyed monofilament suture in the subcuticular layer. This surgical technique for wound closure was the same for both groups as well as the average wound length (about 70 cm).

Patients were further divided into 2 separate groups: (1) a control group that underwent standard abdominal donor site closure and (2) an experimental group that underwent standard abdominal donor site closure plus ciNPWT (PREVENA 125; KCI, a 3M Company)

For the purpose of this study, no protocol guided the decision for the ciNPWT placement, and the donor site incision was consistently closed utilizing the same technique across all patients included in the analysis. Both groups were compared in terms of the aforementioned abdominal donor site complications.

Statistical Analysis

Mean and range were used to describe normally distributed continuous variables. Univariate analysis using unpaired Student t test and Mann-Whitney test were used to compare normal and not normally distributed continuous data, respectively. Fisher exact test and χ 2 test were used to compare categorical data. Statistical significance was set at a P value less than .05. All statistical analyses were performed using IBM SPSS software version 3.154 (IBM).

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