Preoperative NPWT Reduces Complications After Musculocutaneous Flap Reconstruction

Researchers at the Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine in Yangsan, Korea conducted a study to investigate whether preoperative negative pressure wound therapy (NPWT) affected complications after musculocutaneous flap reconstruction of pressure injury wounds requiring surgical treatment.

To conduct their study, the researchers applied NPWT to 71 patients who had undergone surgical reconstruction for sacral pressure injury wounds that were stage 3 or higher—as classified by the 2019 National Pressure Injury Advisory Panel—between April 2018 and March 2020.

Of the 71 patients included in the study, 28 did not undergo preoperative NPWT (no-NPWT group), while 43 received preoperative NPWT. Flap coverage for pressure injury wounds was administered to all patients. Then, the researchers compared complication differences between the 2 groups for wound dehiscence, hematoma, and seroma, which can occur after flap coverage.

Of the 71 cases studied, the researchers noted 16 cases of complications (22.5%). Complication rates were 25.0% in the no-NPWT group, with wound dehiscence and seroma being the most common, and 20.9% in the NPWT group. Hematoma only occurred in the NPWT group and was more frequent in patients with a longer application period of preoperative NPWT.

“We found that NPWT can be helpful in effective and efficient wound management before the surgical reconstruction of sacral pressure injuries and may reduce postoperative complications,” the researchers noted. “However, prolonged application of NPWT could increase the risk of postoperative hematoma. In addition, bleeding control should be prioritized during the surgery.”

Reference

Kim MW, Oh WS, Lee NR, Lee JW, Jeong DK, Nam SB. Effects of preoperative negative pressure wound therapy on complications after musculocutaneous flap reconstruction of sacral pressure injuries. J Wound Manag Res. 2022;18(1):17-22. doi:10.22467/jwmr.2021.01802