Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty.
26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated.
None of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery.
The piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes.
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Over 30% of the US population is obese and nearly 300,000 patients undergo bariatric surgery every year. Patients seeking body-contouring procedures face a staggering rate of surgical complications caused by obesity-associated systemic and local factors impairing wound healing. Closed incision negative-pressure therapy (ciNPT) systems could improve surgical outcomes in these patients. Here, we tested this hypothesis in a retrospective case-control series of post-bariatric patients undergoing an abdominoplasty.
We reviewed the clinical data of 11 post-bariatric patients (average BMI 34) who had undergone an abdominoplasty followed by either standard post-operative wound treatment (control) or ciNPT (at 125 mmHg for 8 days). Data (follow-up 90 days) was analyzed, measuring the time to heal of wounds (primary end-point), the rate of local surgical complications, and the quality of scars (Vancouver Scar Scale, VSS) (secondary endpoints).
No discomfort was associated with the use of ciNPT. Surgical wounds healed two times faster in patients treated with ciNPT compared to controls (time-to-dry: 10.8 ± 5 days vs. 23 ± 7). ciNPT was associated with a significantly lower rate of minor local complications (0%) compared to controls (80%), leading to shorter hospitalization, less dressing changes, and lower costs for the care of wounds with minor complications. One patient in the ciNPT group developed a major local complication (hematoma). The VSS demonstrated a higher quality of scars in the ciNPT group at a 90-day follow-up.
ciNPT might reduce the rate of minor local complications in post-bariatric patients undergoing body-contouring procedures, improving surgical outcomes and treatment costs.