Negative Pressure Wound Therapy Does Not Reduce Wound Complications Following Simple Mastectomy: A Retrospective Cohort Study.

BACKGROUND

Negative pressure wound therapy (NPWT) reduces wound complications following oncoplastic breast surgery, yet there is limited evidence supporting its use in mastectomy without reconstruction. This study evaluated the effect of NPWT on post-mastectomy wound complications in a rural Australian centre.

METHODS

A single centre retrospective cohort study assessed simple mastectomy outcomes between 2020 and 2025. Wounds were grouped by post-operative dressing type (NPWT vs. no NPWT). The primary outcome was a composite of aspirated seroma, haematoma, wound dehiscence, and surgical site infection (SSI). Secondary outcomes were individual wound complications and intervention-related outcomes.

RESULTS

The 131 mastectomy wounds were included (NPWT = 59). There was no significant difference in the composite wound outcome between NPWT and no NPWT (62.71% vs. 47.22%; p = 0.077). NPWT had significantly more aspirated seromas (59.32% vs. 40.28%; p = 0.030) but multivariate analysis did not identify a significant association (Multivariate Exp (β) (95% CI): 2.021 (0.958-4.265); p = 0.065). No significant difference was identified in the other secondary outcomes. Diabetes mellitus was independently associated with the composite wound complication (Multivariate Exp (β) (95% CI): 3.349 (1.242-9.031); p = 0.017) and increasing body mass index was associated with SSI (Multivariate Exp (β) (95% CI): 1.064 (1.012-1.119); p = 0.015).

CONCLUSION

NPWT was not associated with reduced wound complications following simple mastectomy. Aspirated seroma was more common for NPWT, but regression analysis found no significant association. A high rate of wound complications poses a significant burden for patients and this regional centre; prospective data is required to determine optimal the way to prevent and manage said complications.