Siegwart Laura Cosima, Tapking Christian, Diehm Yannick Fabian, Haug Valentin Felix, Bigdeli Amir Khosrow, Kneser Ulrich, Kotsougiani-Fischer Dimitra
Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany.
J Clin Med. 2022 May 20;11(10):2887. doi: 10.3390/jcm11102887.
The objective of this study was to examine the impact of closed incision negative pressure therapy (CINPT) on donor site complications and patient perceptions in transverse musculocutaneous gracilis (TMG) flap breast reconstruction. Our institution conducted a retrospective cohort study, including all patients with TMG flap breast reconstruction from 1 January 2010 to 31 December 2021. Patients were grouped according to conventional wound management or CINPT. Outcomes were surgical site complications, fluid drainage, time to drain removal, and in-hospital stay length. A patient survey was created. A total of 56 patients with 83 TMG flaps were included (control group: 35 patients with 53 TMG flaps; CINPT group: 21 patients with 30 TMG flaps). Patient characteristics were similar in both groups. The flap width was significantly larger in the CINPT group (8.0 cm vs. 7.0 cm, = 0.013). Surgical site complications were reduced in the CINPT group without statistical difference (30.0% vs. 50.9%, = 0.064). Fluid drainage and time to drain removal were similar in both groups. The average in-hospital stay was significantly shortened in the CINPT group (10.0 days vs. 13.0 days, = 0.030). The survey excluded pain, skin irritations, and discomfort during sleep and movement in the CINPT group and showed that the patients felt well protected. This study fails to provide compelling evidence for CINPT to enhance incision healing on the donor site in TMG flap breast reconstruction. There was a trend toward reduced surgical site complications on the donor thigh and the in-hospital stay was shortened. Prophylactic CINPT increases patient comfort and provides a feeling of additional wound protection.
本研究的目的是探讨封闭切口负压疗法（CINPT）对横行腹直肌肌皮瓣（TMG）乳房重建供区并发症及患者感受的影响。我们机构进行了一项回顾性队列研究，纳入了2010年1月1日至2021年12月31日期间所有接受TMG皮瓣乳房重建的患者。患者根据传统伤口处理或CINPT进行分组。观察指标包括手术部位并发症、引流量、引流管拔除时间和住院时间。设计了一份患者调查问卷。共纳入56例患者的83个TMG皮瓣（对照组：35例患者的53个TMG皮瓣；CINPT组：21例患者的30个TMG皮瓣）。两组患者的特征相似。CINPT组的皮瓣宽度明显更大（8.0厘米对7.0厘米，P = 0.013）。CINPT组的手术部位并发症有所减少，但无统计学差异（30.0%对50.9%，P = 0.064）。两组的引流量和引流管拔除时间相似。CINPT组的平均住院时间显著缩短（10.0天对13.0天，P = 0.030）。调查问卷排除了CINPT组患者在睡眠和活动期间的疼痛、皮肤刺激和不适，结果显示患者感觉得到了良好的保护。本研究未能提供令人信服的证据表明CINPT可促进TMG皮瓣乳房重建供区切口的愈合。供区大腿的手术部位并发症有减少的趋势，且住院时间缩短。预防性CINPT可提高患者舒适度，并提供额外的伤口保护感。
