Aesthetic surgery journal · 2026
Can the Use of Closed Incision Negative Pressure Wound Therapy in Immediate Prepectoral Breast Reconstruction With Polyurethane-Coated Implants Reduce the Rate of Early Complications?: A Comparative Study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Salgarello Marzia, Lazzeri Domar Niccolò, Visconti Giuseppe, Scardina Lorenzo, D'Archi Sabatino, Di Leone Alba, Franceschini Gianluca, Barone Adesi Liliana
Аннотация
BACKGROUND: Immediate prepectoral breast reconstruction with polyurethane-coated implants provides esthetic and functional benefits compared with subpectoral techniques, but early postoperative complications remain a concern. Closed incision negative pressure wound therapy (ciNPWT) has demonstrated benefits in other surgical fields, though evidence in breast reconstruction is limited.
OBJECTIVES: To evaluate whether ciNPWT reduces early postoperative complications after immediate prepectoral reconstruction with polyurethane-coated implants, particularly in high-risk patients.
METHODS: We retrospectively analyzed 620 patients undergoing unilateral or bilateral conservative mastectomy with immediate prepectoral reconstruction using polyurethane-coated implants between May 2021 and February 2024. Patients were divided into 2 cohorts: 257 treated with ciNPWT and 363 with conventional dressings. Subgroup analyses considered mastectomy flap thickness (0.5-0.6 cm, 0.7-0.9 cm, ≥1.0 cm) and specimen weight (<500 g vs ≥500 g). Early complications (≤30 days) were classified as major (requiring reoperation or hospitalization) or minor.
RESULTS: ciNPWT significantly reduced major complications compared with controls: wound dehiscence (1.17% vs 6.61%), flap ischemia (0% vs 2.2%), major infection (0.39% vs 2.48%), and implant extrusion (0.39% vs 2.2%). Minor complications, including periprosthetic seromas, were also reduced (4.28% vs 5.79%). The protective effect was most evident in patients with thin mastectomy flaps (0.5-0.9 cm) and specimen weight ≥500 g. Correlation between intraoperative flap thickness and preoperative Rancati score confirmed benefits in high-risk patients (Rancati type 1).
CONCLUSIONS: ciNPWT reduces early complications in immediate prepectoral reconstruction, with greatest benefit in high-risk patients. Integration into reconstructive protocols may enhance safety and broaden indications. Prospective randomized trials are warranted.
LEVEL OF EVIDENCE: 3 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.
OBJECTIVES: To evaluate whether ciNPWT reduces early postoperative complications after immediate prepectoral reconstruction with polyurethane-coated implants, particularly in high-risk patients.
METHODS: We retrospectively analyzed 620 patients undergoing unilateral or bilateral conservative mastectomy with immediate prepectoral reconstruction using polyurethane-coated implants between May 2021 and February 2024. Patients were divided into 2 cohorts: 257 treated with ciNPWT and 363 with conventional dressings. Subgroup analyses considered mastectomy flap thickness (0.5-0.6 cm, 0.7-0.9 cm, ≥1.0 cm) and specimen weight (<500 g vs ≥500 g). Early complications (≤30 days) were classified as major (requiring reoperation or hospitalization) or minor.
RESULTS: ciNPWT significantly reduced major complications compared with controls: wound dehiscence (1.17% vs 6.61%), flap ischemia (0% vs 2.2%), major infection (0.39% vs 2.48%), and implant extrusion (0.39% vs 2.2%). Minor complications, including periprosthetic seromas, were also reduced (4.28% vs 5.79%). The protective effect was most evident in patients with thin mastectomy flaps (0.5-0.9 cm) and specimen weight ≥500 g. Correlation between intraoperative flap thickness and preoperative Rancati score confirmed benefits in high-risk patients (Rancati type 1).
CONCLUSIONS: ciNPWT reduces early complications in immediate prepectoral reconstruction, with greatest benefit in high-risk patients. Integration into reconstructive protocols may enhance safety and broaden indications. Prospective randomized trials are warranted.
LEVEL OF EVIDENCE: 3 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.