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Incisional Negative Pressure Wound Therapy in Post-Bariatric Body Contouring: Does it Make a Difference or is it a Dressing that Just Sucks?

Ashley Jordan MD, Jennifer A. Hall BS, James Dove BS, Christopher Sanders MD
Geisinger Medical Center
2020-02-10

Presenter: Jennifer Hall

Affidavit:
Dr. DeSantis

Director Name: Dr. DeSantis

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics

Introduction: Post-bariatric patients undergoing body contouring procedures have a 60-87% increased risk of wound healing complications compared to non-bariatric groups. There is a wealth of basic science and clinical data supporting negative pressure wound therapy's (NPWT) healing capabilities, however its use in the bariatric population is poorly described in the literature. We sought to determine the effects of incisional NPWT on wound healing complications in the massive weight-loss population undergoing body contouring procedures.

Methods: We performed a retrospective, cohort study from December 2016 to April 2019 of seventy-two non-smoking, massive weight-loss patients who had abdominal body contouring. All patients had an incisional NPWT dressing placed post-operatively.

Results: Overall complication rate was 62.5%. The majority of complications were minor wound complications (48.6%) that required local wound care or no treatment. Hematomas contributed 8.3% and dehiscence 2.8% to the overall complication rate. Infection (8.3%) and seroma (5.6%) rates were less than what has been reported in the literature, 22% and 18%, respectively.

Conclusion: The study's complication rate is within the range quoted in the literature. Superficial skin breakdown accounted for almost half of the complications (48.6%). Major complications occurred at lower rates than what is reported in the literature. We postulate that incisional NPWT dressings may have the capability to downgrade the severity of wound healing complications, based upon the underlying mechanics of NPWT and our very low rates of major wound healing complications in comparison to the literature. We believe NPWT helps decrease major complications, especially in the massive weight-loss population.

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