Closed Incision Negative Pressure Therapy in Oncoplastic Surgery Prevents Delays to Adjuvant Therapy

Kyle M Ockerman; Jaimie Bryan; Gayle Wiesemann; Dan Neal; Fady P Marji; Frederik Heath; Suhail Kanchwala; Oluwadamilola Oladeru; Lisa Spiguel; Sarah Sorice-Virk

doi:10.1097/GOX.0000000000005028

Closed Incision Negative Pressure Therapy in Oncoplastic Surgery Prevents Delays to Adjuvant Therapy

Plast Reconstr Surg Glob Open. 2023 May 26;11(5):e5028. doi: 10.1097/GOX.0000000000005028. eCollection 2023 May.

Authors

Affiliations

¹ From the College of Medicine, University of Florida, Gainesville, Fla.
² Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Florida, Gainesville, Fla.
³ School of Medicine, University of California.
⁴ Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Pennsylvania.
⁵ Department of Radiation Oncology, University of Florida, Gainesville, Fla.
⁶ Division of Surgical Oncology, Department of Surgery, University of Florida, Gainesville, Fla.

Abstract

Breast reductions, including oncoplastic breast surgery (OBS), have high postoperative wound healing complication (WHC) rates, ranging from 17% to 63%, thus posing a potential delay in the onset of adjuvant therapy. Incision management with closed incision negative pressure therapy (ciNPT) effectively reduces postoperative complications in other indications. This retrospective analysis compares postoperative outcomes and delays in adjuvant therapy in patients who received ciNPT on the cancer breast versus standard of care (SOC) after oncoplastic breast reduction and mastopexy post lumpectomy.

Methods: Patient demographics, ciNPT use, postoperative complication rates, and time to adjuvant therapy were analyzed from the records of 150 patients (ciNPT = 29, SOC = 121). Propensity score matching was used to match patients based on age, body mass index, diabetes, tobacco use, and prior breast surgery.

Results: In the matched cohort, the overall complication rate of ciNPT-treated cancerous breasts was 10.3% (3/29) compared with 31% (9/29) in SOC-treated cancerous breasts (P = 0.096). Compared with the SOC-treated cancerous breasts, the ciNPT breasts had lower skin necrosis rates [1/29 (3.4%) versus 6/29 (20.7%); P = 0.091] and dehiscence rates [0/29 (0%) versus 8/29 (27.6%); P = 0.004]. In the unmatched cohort, the total number of ciNPT patients who had a delay in adjuvant therapy was lower compared to the SOC group (0% versus 22.5%, respectively; P = 0.007).

Conclusion: Use of ciNPT following oncoplastic breast reduction effectively lowered postoperative wound healing complication rates and, most importantly, decreased delays to adjuvant therapy.