Closed incision negative pressure wound therapy in oncoplastic breast surgery: A single-centre analysis and literature review.

Abstract

Background: Surgical wound complications cause substantial morbidity. Data on the effectiveness of closed incision negative pressure wound therapy (ciNPWT) as a prophylaxis of surgical wound complications in oncoplastic breast surgery (OPBS) is sparse. This study assessed the routine prophylactic use of ciNPWT in OPBS, explored the trend in outcomes associated with its application and compared subsequent wound outcomes with the existing literature.

Method: A single-surgeon retrospective analysis was conducted on OPBS patients from January 2017 to December 2018. Cumulative sum (CUSUM) analysis was adopted to track the trend of wound complication rates over time. Following the exclusion of data potentially skewed by early procedural adaptation, the study compared the remaining cohort's wound complication rates to those reported in current literature.

Results: A total of 209 breast wounds post OPBS were included in the analysis. CUSUM analysis revealed a higher rate of complications at the initial phase of ciNPWT implementation, which significantly decreased and plateaued after eleven months, indicating improved outcome (p < 0.001). Complication rates in the first month of ciNPWT introduction were markedly higher than in the subsequent two-year period (p = 0.02) and was omitted from further analysis. The final ciNPWT cohort showed a significantly lower complication rate than standard dressing usage reported in published studies (16.7 % versus 33.9 %, p < 0.001).

Conclusion: Adoption of prophylactic ciNPWT resulted in gradual decline of wound complications over time, thus shows significant promise in enhancing wound outcomes post OPBS.