Pansements à Pression Négative des Incisions Fermées et des Tissus Mous Environnants dans la Reconstruction du Sein Prépectorale Directe à L’implant, Post Mastectomie: Étude Pilote

Translated title of the contribution: Closed-Incision and Surrounding Soft Tissue Negative Pressure Dressings in Post-Mastectomy Pre-Pectoral Direct-to-Implant Breast Reconstruction: A Pilot Study

Udai S. Sibia, Devinder Singh, Kathryn M. Sidrow, Luther H. Holton

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Closed-incision and surrounding soft tissue negative pressure therapy (cistNPT) is theorized to decrease infection, reduce tissue edema, and promote healing of the mastectomy skin flap. We report our early experience with this dressing in pre-pectoral direct-to-implant (pDTI) breast reconstruction. Methods: We retrospectively reviewed all patients who underwent post-mastectomy pDTI breast reconstruction with cistNPT between July 2019 and February 2020. All reconstructions utilized smooth round silicone gel implants and human acellular dermal matrix. Results: Thirty-five female patients underwent 58 mastectomies. Mean age and body mass index were 49.9 years and 28.9 kg/m2, respectively. Eleven (31.4%) patients had neoadjuvant chemotherapy. The mean sternal notch-to-nipple distance was 27.0 cm. The median specimen weight was 483 g, while the median implant volume was 495 cc. The mean implant-to-specimen ratio was 1.4 for nipple-sparing, 1.1 for skin-sparing, and 0.7 for skin-reducing mastectomy. Total drain volume was 483.1 cc from each breast. Post-operative complications included seroma (5.2%), peri-incisional necrosis (8.6%), and superficial skin epidermolysis (13.8%). There were no cases of surgical site infection, dehiscence, or hematoma. Rate of return to the operative room was 3.4%. Mean follow-up was 90 days. Conclusions: In our series of pDTI breast reconstructions with cistNPT, no patients experienced hematoma, dehiscence, or infection complications. Rates of seroma, skin necrosis requiring operative debridement, and total drain volumes were lower than those reported in literature.

Translated title of the contributionClosed-Incision and Surrounding Soft Tissue Negative Pressure Dressings in Post-Mastectomy Pre-Pectoral Direct-to-Implant Breast Reconstruction: A Pilot Study
Original languageFrench
JournalPlastic Surgery
DOIs
StateAccepted/In press - 2021

Keywords

  • Prevena Restor Bella Form™
  • Prevena Restor Bella•Form™
  • breast drain output
  • closed-incision and surrounding soft tissue negative pressure therapy (cistNPT)
  • direct-to-implant
  • directe à l’implant
  • mastectomy flap necrosis
  • nécrose du lambeau de mastectomie
  • outcomes
  • pre-pectoral
  • pré-pectorale
  • résultats
  • sortie de drain mammaire
  • thérapie par pression négative à incision fermée et autour des tissus mous (cistNPT)

ASJC Scopus subject areas

  • Surgery

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