scholarly journals Use of Closed Incision Negative Pressure Therapy (ciNPT) in Breast Reconstruction Abdominal Free Flap Donor Sites

2021 ◽  
Vol 10 (21) ◽  
pp. 5176
Author(s):  
Jennifer Wang ◽  
Zyg Chapman ◽  
Emma Cole ◽  
Satomi Koide ◽  
Eldon Mah ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Negative Pressure ◽  
Statistical Significance ◽  
Future Research ◽  
Wound Complications ◽  
Negative Pressure Therapy ◽  
Royal Melbourne Hospital ◽  
Pressure Therapy ◽  
The Impact

Background: Closed incision negative pressure therapy (ciNPT) may reduce the rate of wound complications and promote healing of the incisional site. We report our experience with this dressing in breast reconstruction patients with abdominal free flap donor sites. Methods: A retrospective cohort study was conducted of all patients who underwent breast reconstruction using abdominal free flaps (DIEP, MS-TRAM) at a single institution (Royal Melbourne Hospital, Victoria) between 2016 and 2021. Results: 126 female patients (mean age: 50 ± 10 years) were analysed, with 41 and 85 patients in the ciNPT (Prevena) and non-ciNPT (Comfeel) groups, respectively. There were reduced wound complications in almost all outcomes measured in the ciNPT group compared with the non-ciNPT group; however, none reached statistical significance. The ciNPT group demonstrated a lower prevalence of surgical site infections (9.8% vs. 11.8%), wound dehiscence (4.9% vs. 12.9%), wound necrosis (0% vs. 2.4%), and major complication requiring readmission (2.4% vs. 7.1%). Conclusion: The use of ciNPT for abdominal donor sites in breast reconstruction patients with risk factors for poor wound healing may reduce wound complications compared with standard adhesive dressings; however, large scale, randomised controlled trials are needed to confirm these observations. Investigation of the impact of ciNPT patients in comparison with conventional dressings, in cohorts with equivocal risk profiles, remains a focus for future research.

scholarly journals The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes

2018 ◽  
Vol 6 (8) ◽  
pp. e1880 ◽  
Author(s):  
Allen Gabriel ◽  
Steven Sigalove ◽  
Noemi Sigalove ◽  
Toni Storm-Dickerson ◽  
Jami Rice ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
The Impact

Effect of Novel Anteromedial Approach on Wound Complications Following Ankle Arthroplasty

2020 ◽  
Vol 41 (10) ◽  
pp. 1198-1205
Author(s):  
Mansur M. Halai ◽  
Ellie Pinsker ◽  
Timothy R. Daniels
Keyword(s):  
Surgical Approach ◽  
Negative Pressure ◽  
Inflammatory Arthritis ◽  
Wound Complications ◽  
Nurse Specialist ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Ankle Arthroplasty ◽  
Factors Associated ◽  
Major Complications

Background: The purpose of this study was to evaluate all wound complications following total ankle arthroplasty (TAA) before and after the implementation of a novel extensile anteromedial surgical approach. We further investigated patients and operative factors associated with wound complications. Methods: A series of 660 TAAs were collected. The median follow-up was 84 months (range, 12-204 months). Minor wound complications included discoloration, swelling, or clinical concern that merited bringing the patient back sooner for review. Major wound complications included plastic surgical consultation, debridement by the nurse specialist, negative pressure therapy, or reoperation. All major complications initially had a course of empirical oral antibiotics. Since 2011, higher-risk patients have had their TAA performed through an extensile anteromedial approach. Results: Fifty-six patients (8.5%) had wound healing issues (17 major [2.6%], 39 minor [5.9%]). All issues became evident <21 days postoperatively. Inflammatory arthritis, smoking, and coronary disease were patient factors associated with major wound complications. Four patients were treated with negative pressure therapy, 4 with debridement in the operating room, and 2 eventually converted to fusions. Fourteen patients (82%) who had major complications had an ancillary procedure to balance the TAA through a separate incision. All major wound complications had an anterior surgical approach for their TAA. Before 2011, there were 13 major wound complications. Since 2012, there have been 4 major wound complications overall, with no wound complications in the anteromedial approach cohort. Conclusion: We recommend an extensile anteromedial approach for smokers and patients with heart disease or inflammatory arthritis undergoing TAA. If a wound complication developed, a multidisciplinary team to evaluate wounds was useful. Level of Evidence: Level III, retrospective comparative series.

scholarly journals RS06 A Randomized Study Evaluating Negative-Pressure Therapy to Decrease Vascular Groin Wound Complications

2017 ◽  
Vol 65 (6) ◽  
pp. 133S ◽  
Author(s):  
Paul DiMuzio ◽  
Cara Staley ◽  
David Reiter ◽  
Megan McCullough ◽  
Selena Goss ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Randomized Study ◽  
Wound Complications ◽  
Negative Pressure Therapy ◽  
Pressure Therapy

scholarly journals Effect of Incisional Negative Pressure Wound Therapy vs Standard Wound Dressing on the Development of Surgical Site Infection after Spinal Surgery: A Prospective Observational Study

Neurosurgery ◽  
2021 ◽  
Author(s):  
Kyle B Mueller ◽  
Matthew D’Antuono ◽  
Nirali Patel ◽  
Gnel Pivazyan ◽  
Edward F Aulisi ◽  
...  
Keyword(s):  
Observational Study ◽  
Spine Surgery ◽  
Negative Pressure ◽  
Spinal Surgery ◽  
Prospective Observational Study ◽  
Statistical Significance ◽  
High Risk Patient ◽  
Surgical Site Infections ◽  
Pressure Therapy ◽  
The Impact

Abstract BACKGROUND Use of a closed-incisional negative pressure therapy (ci-NPT) dressing is an emerging strategy to reduce surgical site infections (SSIs) in spine surgery that lacks robust data. OBJECTIVE To determine the impact of a ci-NPT, as compared with a standard dressing, on the development of SSIs after spine surgery. METHODS This was a prospective observational study over a 2-yr period. Indications for surgery included degenerative disease, deformity, malignancy, and trauma. Exclusion criteria included anterior and lateral approaches to the spine, intraoperative durotomy, or use of minimally invasive techniques. SSIs up to 60 d following surgery were recorded. RESULTS A total of 274 patients were included. SSI rate was significantly lower with ci-NPT dressing (n = 118) as compared with the standard dressing (n = 156) (3.4 vs 10.9%, P = .02). There was no statistical difference in infection rate for decompression alone procedures (4.2 vs 9.1%, P = .63), but there was a statistically significant reduction with the use of a negative-pressure dressing in cases that required instrumentation (3.2 vs 11.4%, P = .03). Patients at higher risk (instrumentation, deformity, and malignancy) had less SSIs with the use of ci-NPT, although this did not reach statistical significance. There were no complications in either group. CONCLUSION SSI rates were significantly reduced with a ci-NPT dressing vs a standard dressing in patients who underwent spinal surgery. The higher cost of a ci-NPT dressing might be justified with instrumented cases, as well as with certain high-risk patient populations undergoing spine surgery, given the serious consequences of an infection.

scholarly journals The impact of surgical site occurrences and the role of closed incision negative pressure therapy

2016 ◽  
Vol 13 (S3) ◽  
pp. 35-46 ◽  
Author(s):  
Christian Willy ◽  
Michael Engelhardt ◽  
Marcus Stichling ◽  
Onnen Grauhan
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
The Impact
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