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Abstract：
BACKGROUND: The objective of this study was to investigate whether closed incisional negative pressure therapy (cINPT) is suitable to improve anterior lateral thigh (ALT) flap donor site healing and scarring.
METHODS: We identified 271 ALT free flaps of widths between 7 and 9 cm and primary donor site closure performed between January 2012 to December 2019. Patients were divided into cases of cINPT versus controls without cINPT as part of this retrospective case-control review. We compared the incidences of postoperative donor site complications (wound dehiscence, infection, seroma, hematoma) and the degree of scarring severity using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scales (POSAS).
RESULTS: A total of 106 ALT donor sites received cINPT (39%), whereas the remaining 165 donor sites received conventional dressings (61%). The distribution of gender, age, body mass index, comorbidities, and mean flap sizes were comparable between both groups. The occurrence of surgical wound dehiscence was significantly lower in the cINPT group (2.8%), when compared to controls (9.0%) (p = 0.04). Furthermore, the mean length of postoperative hospital stay was significantly shorter in the cINPT group (19 ± 8 days versus 21 ± 11 days; p = 0.03). CINPT was associated with a more favorable donor site scar quality when assessed by VSS (p = 0.03) and POSAS (p = 0.002).
CONCLUSIONS: The use of cINPT was associated with significantly less ALT donor site complications and superior scar quality accelerating patients\' postoperative recovery.
METHODS: We identified 271 ALT free flaps of widths between 7 and 9 cm and primary donor site closure performed between January 2012 to December 2019. Patients were divided into cases of cINPT versus controls without cINPT as part of this retrospective case-control review. We compared the incidences of postoperative donor site complications (wound dehiscence, infection, seroma, hematoma) and the degree of scarring severity using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scales (POSAS).
RESULTS: A total of 106 ALT donor sites received cINPT (39%), whereas the remaining 165 donor sites received conventional dressings (61%). The distribution of gender, age, body mass index, comorbidities, and mean flap sizes were comparable between both groups. The occurrence of surgical wound dehiscence was significantly lower in the cINPT group (2.8%), when compared to controls (9.0%) (p = 0.04). Furthermore, the mean length of postoperative hospital stay was significantly shorter in the cINPT group (19 ± 8 days versus 21 ± 11 days; p = 0.03). CINPT was associated with a more favorable donor site scar quality when assessed by VSS (p = 0.03) and POSAS (p = 0.002).
CONCLUSIONS: The use of cINPT was associated with significantly less ALT donor site complications and superior scar quality accelerating patients\' postoperative recovery.
摘要：
背景：本研究的目的是探讨闭合性切口负压治疗（cINPT）是否适合改善大腿前外侧（ALT）皮瓣供体部位的愈合和瘢痕形成。
方法：我们确定了在2012年1月至2019年12月之间进行的271个ALT游离皮瓣，宽度在7至9厘米之间，主要供体部位闭合。作为回顾性病例对照审查的一部分，将患者分为cINPT病例和无cINPT的对照组。我们比较了术后供体部位并发症的发生率（伤口裂开，感染,血清肿,血肿）和使用温哥华疤痕量表（VSS）和患者和观察者疤痕评估量表（POSAS）的疤痕严重程度。
结果：共有106个ALT供体部位接受了cINPT（39％），而其余的165个供体部位接受了常规敷料(61%)。性别的分布,年龄,身体质量指数,合并症,两组的平均皮瓣大小相当。cINPT组手术伤口裂开的发生率明显降低(2.8%),与对照组相比（9.0％）（p=0.04）。此外，cINPT组术后平均住院时间显著缩短(19±8天比21±11天;p=0.03).当通过VSS（p=0.03）和POSAS（p=0.002）评估时，CINPT与更有利的供体部位瘢痕质量相关。
结论：使用cINPT与ALT供体部位并发症明显减少和瘢痕质量高加速患者术后恢复相关。
方法：我们确定了在2012年1月至2019年12月之间进行的271个ALT游离皮瓣，宽度在7至9厘米之间，主要供体部位闭合。作为回顾性病例对照审查的一部分，将患者分为cINPT病例和无cINPT的对照组。我们比较了术后供体部位并发症的发生率（伤口裂开，感染,血清肿,血肿）和使用温哥华疤痕量表（VSS）和患者和观察者疤痕评估量表（POSAS）的疤痕严重程度。
结果：共有106个ALT供体部位接受了cINPT（39％），而其余的165个供体部位接受了常规敷料(61%)。性别的分布,年龄,身体质量指数,合并症,两组的平均皮瓣大小相当。cINPT组手术伤口裂开的发生率明显降低(2.8%),与对照组相比（9.0％）（p=0.04）。此外，cINPT组术后平均住院时间显著缩短(19±8天比21±11天;p=0.03).当通过VSS（p=0.03）和POSAS（p=0.002）评估时，CINPT与更有利的供体部位瘢痕质量相关。
结论：使用cINPT与ALT供体部位并发症明显减少和瘢痕质量高加速患者术后恢复相关。
