Impact of closed-incision negative pressure therapy in donor-site complications in DIEP flap breast reconstruction: Analysis of 705 patients and 1125 flaps.
Research article published in Journal of plastic, reconstructive & aesthetic surgery : JPRAS (2025)
Abstract
BACKGROUND: Closed-incision negative pressure therapy (ciNPT) has been shown to reduce complication rates in breast reconstruction (BR). This study aimed to evaluate postoperative outcomes in deep inferior epigastric perforator (DIEP) donor-site incisions managed with ciNPT compared to standard dressings. METHODS: We performed a retrospective study of patients ≥18 years who underwent DIEP flap BR from 2015 to 2023. Patients who underwent reconstruction with alternative flaps or converted to transverse rectus abdominus myocutaneous were excluded. Patients were categorized according to the use of ciNPT vs. standard dressings. The unpaired t- and Fisher's Exact tests were used to assess the differences between the groups. Multivariable logistic regression models were used to evaluate postoperative complications. RESULTS: A total of 705 patients were included, with 68 (9.6%) managed with ciNPT. Patients treated with ciNPT had significantly higher mean body mass index (BMI) (34.0 vs. 28.5 kg/m2; p<0.001) compared to the control group. Higher rates of alcohol use (59.2% vs. 41.2%; p=0.006) and hormonal therapy use (41.3% vs. 17.9%; p<0.001) were found in the standard dressing group. Univariate analyses showed no significant differences in donor-site postoperative outcomes across the groups. However, multivariate logistic regression models demonstrated a reduced likelihood of surgical site infection (OR 0.187; 95% CI 0.045-0.768); p=0.020), and wound dehiscence (OR 0.338; 95% CI 0.155-0.738); p=0.006) among the ciNPT users. Particularly, in patients with BMI >30 kg/m2, ciNPT use (OR 0.282; 95% CI 0.098-0.812; p=0.019) was found to be a significant protective factor against wound complications compared to the standard of care. CONCLUSIONS: Our findings suggest that ciNPT may improve wound complication rates in DIEP flap donor sites, especially in patients with high BMI. Further research is necessary to elucidate the cost-effectiveness of ciNPT based on the patient risk profiles.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Closed-incision negative pressure therapy (ciNPT) has been shown to reduce complication rates in breast reconstruction (BR). This study aimed to evaluate postoperative outcomes in deep inferior epigastric perforator (DIEP) donor-site incisions managed with ciNPT compared to standard dressings.
Почему это важно для гирудотерапии
В данном крупном ретроспективном исследовании 705 пациентов оценивалось, снижает ли терапия с отрицательным давлением на закрытую рану (ciNPT) частоту осложнений в донорской зоне при реконструкции молочной железы лоскутом DIEP по сравнению со стандартными повязками. Многофакторный анализ показал, что ciNPT снижала частоту инфекций области хирургического вмешательства и расхождения краёв раны, особенно у пациентов с ИМТ >30. Исследование является лишь косвенно релевантным для области ASH, поскольку реконструкция молочной железы свободным лоскутом может сопровождаться осложнениями, при которых медицинская пиявочная терапия может вспомогательно применяться при венозном застое. В аннотации не упоминаются ни пиявки, ни гирудотерапия, ни ведение венозного застоя, что делает релевантность данной работы непрямой.
Цитирование
Impact of closed-incision negative pressure therapy in donor-site complications in DIEP flap breast reconstruction: Analysis of 705 patients and 1125 flaps.
Escobar-Domingo et al. · Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2025
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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