Assessment of patient reported outcomes for closed incision negative pressure therapy with wide-coverage dressings in simple mastectomy and immediate breast reduction

Benjamin Baker, Andrew Pieri
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Introduction

Closed incision negative pressure therapy (ciNPT) is an increasingly widespread method of managing the healing surgical incision, particularly after surgeries with high risk of postoperative complication. Recently, this approach can be paired with a new dressing configuration that covers the incision and a broader area of peri-incisional tissues, which has been used effectively in multiple surgery types and anatomical areas. In our hospital, ciNPT with wide-coverage dressings* has been integrated into the postoperative protocol following simple mastectomy (SM) or skin-sparing mastectomy with immediate implant-based reconstruction (IBR), covering the incision and entire breast. The aim of this study is to retrospectively assess the patient-reported outcomes of this new protocol.


Methods:


Patients included in the study underwent SM or skin-sparing mastectomy with immediate IBR for breast cancer. When necessary, axillary surgery was completed simultaneously. In the operating room, ciNPT with wide-coverage dressings were placed over the entire breast,  and set to -125 mmHg negative pressure for 14 days. On postoperative day 14, the dressings were removed, and patients were asked to complete the validated Wound-Q™ suction device scale consisting of 9 items. Scores were summed and converted to equivalent Rasch transformed Q scores from 0-100. Additional wound experience questions were asked, alongside space for free text comments. The patients also recorded their satisfaction rating on a Likert scale ranging 1-5.


Results:

Twenty-five patients participated in the study, including 13 undergoing SM and 12 undergoing IBR. The median age was 62 years (IQR 52-75 years). Patients in the SM group were significantly older (p<0.01). The number of bilateral cases and patients that underwent axillary surgery at the same time were similar between groups. Patients rated the ciNPT device highest on items relating to its function and appearance, and lowest on items relating to the amount of noise it made, sleep, and the ability to perform physical activity when using it. The overall mean score for the combined cohort was 64.8/100. The mean score for patients in the SM group (74.8±19.9) was significantly greater than for the IBR group (53.9±9.6, p<0.01). The mean overall patient satisfaction rating was 3.92/5; 4.0 in the SM group and 3.8 in the IBR group.


Conclusion:

Overall, the dressing was well tolerated by patients, and satisfaction was high. The positive reception of ciNPT with wide coverage dressings supports continued use at our hospital.

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