Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial

Background: The effectiveness of closed incision negative pressure wound therapy (ciNPWT) has been shown across various studies. However, studies with large patient cohorts comprising post-bariatric patient populations are missing. The objective of this research was to assess the influence of ciNPWT...

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Main Authors: Torsten Schulz, Toralf Kirsten, Katharina Theresa Vogel, Stefan Langer, Rima Nuwayhid
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587824001323
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author Torsten Schulz
Toralf Kirsten
Katharina Theresa Vogel
Stefan Langer
Rima Nuwayhid
author_facet Torsten Schulz
Toralf Kirsten
Katharina Theresa Vogel
Stefan Langer
Rima Nuwayhid
author_sort Torsten Schulz
collection DOAJ
description Background: The effectiveness of closed incision negative pressure wound therapy (ciNPWT) has been shown across various studies. However, studies with large patient cohorts comprising post-bariatric patient populations are missing. The objective of this research was to assess the influence of ciNPWT on post-operative wound complications in this demanding patient collective. Methods: We conducted a retrospective case-control study. Between 1 January 2013 and 31 December 2023, a total of 251 abdominoplasty procedures following massive weight loss were identified. Patients were matched based on resection weights. We matched 118 patients separated into two groups depending on post-surgical wound management (conventional wound dressings vs ciNPWT). The primary outcomes were wound-related disorders and secondary outcomes were the number of readmissions or reoperations within 30 days after the initial surgery. Results: The study revealed equal incidence of seroma formation (15 vs 15, p = 1.0), rates of wound dehiscence (23 vs 20, p = 0.56), surgical site infection (11 vs 6, p = 0.18), hematoma (17 vs 9, p = 0.07), complete removal of all drainages (6.7 vs 6.1 days, p = 0.34) and total number of readmission (12 vs 11, p = 0.77) or reoperations (12 vs 10, p = 0.63) within 30 days. The second hospital stay caused by revision was significantly shorter in the ciNPWT group (5.8 days vs 12.0 days, p = 0.02). Conclusion: Consequently, we did not find evidence to support the hypothesis that ciNPWT reduces complications after abdominoplasty in patients with massive weight loss.
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spelling doaj-art-59fe7ab11c47424794dbcc574df98a9a2025-08-20T02:20:58ZengElsevierJPRAS Open2352-58782024-12-014219720710.1016/j.jpra.2024.09.004Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trialTorsten Schulz0Toralf Kirsten1Katharina Theresa Vogel2Stefan Langer3Rima Nuwayhid4Department of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany; Correspondence address: Dr. med. Torsten Schulz, University Hospital Leipzig, Department of Plastic, Aesthetic and Special Hand Surgery, Liebigstraße 20, 04103 Leipzig. Phone: +49 (0) 341 97-17140; Fax: +49 (0)341 97-17309.Medical Informatics Center, Department of Medical Data Science, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyBackground: The effectiveness of closed incision negative pressure wound therapy (ciNPWT) has been shown across various studies. However, studies with large patient cohorts comprising post-bariatric patient populations are missing. The objective of this research was to assess the influence of ciNPWT on post-operative wound complications in this demanding patient collective. Methods: We conducted a retrospective case-control study. Between 1 January 2013 and 31 December 2023, a total of 251 abdominoplasty procedures following massive weight loss were identified. Patients were matched based on resection weights. We matched 118 patients separated into two groups depending on post-surgical wound management (conventional wound dressings vs ciNPWT). The primary outcomes were wound-related disorders and secondary outcomes were the number of readmissions or reoperations within 30 days after the initial surgery. Results: The study revealed equal incidence of seroma formation (15 vs 15, p = 1.0), rates of wound dehiscence (23 vs 20, p = 0.56), surgical site infection (11 vs 6, p = 0.18), hematoma (17 vs 9, p = 0.07), complete removal of all drainages (6.7 vs 6.1 days, p = 0.34) and total number of readmission (12 vs 11, p = 0.77) or reoperations (12 vs 10, p = 0.63) within 30 days. The second hospital stay caused by revision was significantly shorter in the ciNPWT group (5.8 days vs 12.0 days, p = 0.02). Conclusion: Consequently, we did not find evidence to support the hypothesis that ciNPWT reduces complications after abdominoplasty in patients with massive weight loss.http://www.sciencedirect.com/science/article/pii/S2352587824001323Negative pressure wound therapyAbdominoplastyComplicationsVACSeromaMassive weight loss
spellingShingle Torsten Schulz
Toralf Kirsten
Katharina Theresa Vogel
Stefan Langer
Rima Nuwayhid
Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial
JPRAS Open
Negative pressure wound therapy
Abdominoplasty
Complications
VAC
Seroma
Massive weight loss
title Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial
title_full Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial
title_fullStr Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial
title_full_unstemmed Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial
title_short Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial
title_sort pressure makes diamonds the impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss results from a case controlled trial
topic Negative pressure wound therapy
Abdominoplasty
Complications
VAC
Seroma
Massive weight loss
url http://www.sciencedirect.com/science/article/pii/S2352587824001323
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