Clark Alexa, Sherrer James, Grover Karina, Shauly Orr, Gould Daniel J, Losken Albert
From the Emory School of Medicine, Atlanta, GA.
Department of Medicine, University of California, Los Angeles, Los Angeles, CA.
Plast Reconstr Surg Glob Open. 2025 Jul 18;13(7):e6979. doi: 10.1097/GOX.0000000000006979. eCollection 2025 Jul.
Negative-pressure wound therapy (NPWT) has been shown to facilitate complex wound closure, decrease healing complications, and improve scar quality. Recently, its application in closed incision wound healing has been studied. Although relatively new to plastic surgery, outcomes and complication rates of NPWT compared with conventional dressings following breast surgery have been increasingly studied. The purpose of this study is to review the literature to evaluate the efficacy of NPWT over standard-of-care closure in breast reconstruction and aesthetic surgery.
A PubMed search was performed following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to assess the use of NPWT in women 18 years or older who received breast reconstruction, augmentation, or reduction surgery. After abstract, full-text, and reference review, 13 articles were evaluated, and postoperative complications, such as seroma, hematoma, and infection incidence, were extracted.
Of the 10 articles that reported overall complication rates, 6 showed significant decreases in complications for breasts treated with an NPWT approach. All types of breast surgery and wound vacuum brands were used within these 6 studies. Patients who underwent breast reduction did not show a significant rise in hematoma or seroma formation with the use of NPWT. However, 2 studies reported a notable increase in seroma formation following breast reconstruction and augmentation surgery. There was no significant difference in infection rates between control and NPWT groups. Three studies primarily reporting bilateral breast reduction outcomes found a significantly decreased rate of wound dehiscence postoperatively compared with the standard dressing.
NPWT is a promising alternative to standard-of-care dressings for mitigating postoperative wound healing complications in breast reconstruction, augmentation, and reduction. Limitations of this review include the lack of statistical comparison due to the small number of available studies and the minimal consistency of primary outcomes reported within breast surgery research. Even so, NPWT demonstrates an overall decrease in complications and provides a novel approach to enhancing cosmesis and healing of breast incisions postoperatively.
负压伤口治疗（NPWT）已被证明有助于复杂伤口的闭合，减少愈合并发症，并改善瘢痕质量。最近，其在闭合切口伤口愈合中的应用受到了研究。尽管NPWT在整形手术中相对较新，但与乳房手术后的传统敷料相比，NPWT的疗效和并发症发生率已得到越来越多的研究。本研究的目的是回顾文献，以评估NPWT在乳房重建和美容手术中相对于标准护理闭合方法的疗效。
按照系统评价和Meta分析的首选报告项目指南，在PubMed上进行搜索，以评估NPWT在接受乳房重建、隆乳或缩乳手术的18岁及以上女性中的应用。经过摘要、全文和参考文献审查，评估了13篇文章，并提取了术后并发症，如血清肿、血肿和感染发生率。
在报告总体并发症发生率的10篇文章中，6篇显示采用NPWT方法治疗的乳房并发症显著减少。这6项研究使用了所有类型的乳房手术和伤口负压品牌。接受缩乳手术的患者使用NPWT后，血肿或血清肿形成没有显著增加。然而，2项研究报告乳房重建和隆乳手术后血清肿形成显著增加。对照组和NPWT组之间的感染率没有显著差异。三项主要报告双侧缩乳结果的研究发现，与标准敷料相比，术后伤口裂开率显著降低。
NPWT是一种有前景的替代标准护理敷料的方法，可减轻乳房重建、隆乳和缩乳术后的伤口愈合并发症。本综述的局限性包括由于可用研究数量少以及乳房手术研究中报告的主要结局一致性最小而缺乏统计比较。即便如此，NPWT总体上显示出并发症减少，并为术后改善乳房切口的美容效果和愈合提供了一种新方法。
