1. The effect of postoperative closed incision negative pressure therapy on the incidence of donor site wound dehiscence in breast reconstruction patients: DEhiscence PREvention Study (DEPRES), pilot randomized controlled trial
- Author
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H.E.W. de Laat, Stefan Hummelink, Dietmar J.O. Ulrich, Jeroen W. B. Peters, and E. Muller-Sloof
- Subjects
Adult ,medicine.medical_specialty ,Pilot Projects ,Dermatology ,030230 surgery ,Dehiscence ,Surgical Flaps ,Pathology and Forensic Medicine ,law.invention ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Randomized controlled trial ,Risk Factors ,law ,Diabetes mellitus ,Surgical Wound Dehiscence ,Humans ,Surgical Wound Infection ,Medicine ,Single-Blind Method ,Prospective Studies ,business.industry ,Wound dehiscence ,Incidence ,Incidence (epidemiology) ,Postoperative complication ,Surgical wound ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Surgery ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,030220 oncology & carcinogenesis ,Female ,business ,Breast reconstruction ,Negative-Pressure Wound Therapy - Abstract
Contains fulltext : 200454.pdf (Publisher’s version ) (Open Access) AIM: Wound dehiscence is a serious postoperative complication associated both with high morbidity and mortality. It has a significant rate of occurrence in breast reconstruction surgeries with a deep internal epigastric perforator (DIEP) and with a profunda artery perforator (PAP) flap. Risk factors for wound dehiscence include smoking, diabetes mellitus, chronic obstructive pulmonary disease, and obesity. The aim of this pilot study was to assess whether postoperative treatment with closed incision negative pressure therapy (ciNPT) decreases the incidence of donor site wound dehiscence in breast reconstruction patients. METHOD: Women undergoing a breast reconstruction with a DIEP or PAP flap were enrolled in a pilot randomized controlled trial and assigned treatment with either ciNPT or adhesive strips. The primary outcome was wound dehiscence upon follow-up after four weeks. Secondary outcomes that were evaluated included wound infection, pain, and allergy. There was no loss to follow-up. RESULTS: This pilot study included 51 women (n=25 ciNPT, n=26 adhesive strips). The two groups did not differ significantly in patients demographics or comorbidities. Wound dehiscence occurred in 11 patients (n=2 ciNPT, n=9 adhesive strips). This difference was statistically significant: p=0.038. There were no statistically significant differences in secondary outcomes between the two groups. CONCLUSION: In this pilot study, postoperative treatment with ciNPT decreased the incidence of donor site wound dehiscence in breast reconstruction patients. Further research is ongoing by the same hospital. This trial was registered in the Netherlands Trial Register (NTR) under ID no. NTR5808.
- Published
- 2018