Incision and Surrounding Soft Tissue Management of the Breast Using Closed Incision Negative Pressure Therapy With Full-Coverage Dressings

 For patients undergoing breast surgery, incisional management can have a significant impact on healing outcomes and patient satisfaction. Closed incision negative pressure therapy (ciNPT) using a novel foam dressing that covers breast incisions, the nipple-areolar complex, and surrounding tissues*, creates a barrier against external contaminants, removes fluid and infectious materials, reduces edema, and bolsters the breast by holding the incisional edges together. We report the outcomes of 7 patients undergoing breast surgery followed by ciNPT with full-coverage dressings. The patients comprised 1 male and 6 females aged 21 to 49 years old. Patient medical history included weight loss greater than 50 pounds, fibromyalgia, polycystic ovarian disease, endometriosis, and smoking. Body mass indices were 25.6 to 32.4 kg/m2. Surgery types included breast reduction (n=3), breast augmentation (n=2), implant exchange (n=1), and bilateral mastectomy for male gynecomastia (n=1). Incision lengths ranged from 23 to 40 (mean: 32.9) cm, and all were closed using buried subcuticular sutures. Patients received prophylactic antibiotics and ciNPT with full-coverage dressings at -125 mmHg. Four patients were immediately discharged for outpatient care, 2 patients were discharged on postoperative Day (POD) 1, and 1 patient was discharged on POD 2. On POD 7, ciNPT was discontinued, and all incisions remained closed. Within the 30-day follow-up period, 1 patient experienced a minor dehiscence of the left breast and another patient developed a small seroma on POD 15, but there were no signs of infection and no intervention was required. Upon follow-up 3 to 5 months post-surgery, we observed an overall reduction in swelling, less pain, improved range of motion, and improved scar appearance. In this patient population, we report that ciNPT with full-coverage dressings provided support for incision healing after breast surgery by protecting the incisional environment and moving fluid away from the surgical site.

Trademarked Items (if applicable): *PREVENA RESTOR BELLAFORM™ Incision Management System (KCI, now a part of 3M Company; San Antonio, TX)

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