Lombardo Giuseppe Angelo Giovanni, Ciancio Francesco, Giardino Francesco Ruben, Stivala Alessio, Melita Dario, Marchica Paolo, Ranno Rosario, Marrella Domenico
Burn and Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy.
Università Unikore Di Enna, Piazza Dell'Università, 94100, Enna, Italy.
Updates Surg. 2025 Apr 23. doi: 10.1007/s13304-025-02207-z.
The donor-site wound from deep inferior epigastric perforator flap breast reconstruction differs from abdominoplasty due to higher positioning and tension, potentially affecting healing. Closed-incision negative-pressure therapy has been proposed to improve wound healing and reduce complications. This study aimed to evaluate the impact of this tool on donor-site wound's complications and scar-related patient outcomes. This retrospective cohort study included 140 patients who underwent delayed deep inferior epigastric perforator flap breast reconstruction between September 2020 and March 2023. Patients were assigned to Group A (closed-incision negative-pressure therapy) or group B (micropore tape dressings). Both groups received standardized perioperative care. Complications were analyzed, and scar were assessed 1 year postoperatively using SCAR-Q. Statistical significance was set at p ≤ 0.05. There were no significant differences between the two groups in baseline characteristics. Wound dehiscence was significantly lower in Group A compared to Group B (p = 0.0003). The mean time to wound healing after dehiscence was similar between groups (p = 0.270). No significant differences were found in other complications, such as infection or hematoma. Concerning SCAR-Q, patients in Group A reported significantly better outcomes on the symptom scale (p = 0.03), whereas no significant differences were observed for appearance or psychosocial impact. Closed-incision negative-pressure therapy reduced the rate of wound dehiscence but did not significantly improve scar quality or other complications. Given the limited benefits and lack of cost-effectiveness data, this tool should be considered for further study rather than routine clinical use in low-risk deep inferior epigastric perforator flap patients.
腹壁下深动脉穿支皮瓣乳房重建供区伤口因位置较高和张力较大，与腹壁成形术不同，这可能会影响愈合。有人提出采用闭合切口负压疗法来促进伤口愈合并减少并发症。本研究旨在评估该方法对供区伤口并发症及与瘢痕相关的患者预后的影响。这项回顾性队列研究纳入了2020年9月至2023年3月期间接受延迟腹壁下深动脉穿支皮瓣乳房重建的140例患者。患者被分为A组（闭合切口负压疗法）或B组（微孔胶带敷料）。两组均接受标准化围手术期护理。分析并发症情况，并在术后1年使用瘢痕质量量表（SCAR-Q）评估瘢痕。设定统计学显著性水平为p≤0.05。两组患者的基线特征无显著差异。A组伤口裂开发生率显著低于B组（p = 0.0003）。两组伤口裂开后愈合的平均时间相似（p = 0.270）。在感染或血肿等其他并发症方面未发现显著差异。关于瘢痕质量量表，A组患者在症状量表上的预后明显更好（p = 0.03），而在外观或心理社会影响方面未观察到显著差异。闭合切口负压疗法降低了伤口裂开率，但并未显著改善瘢痕质量或其他并发症。鉴于益处有限且缺乏成本效益数据，对于低风险腹壁下深动脉穿支皮瓣患者，该方法应考虑进一步研究而非常规临床应用。
