Background: 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.
Methods: 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).
Results: 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.
Conclusions: ciNPT might reduce the rate of minor local complications in post-bariatric patients undergoing body-contouring procedures, improving surgical outcomes and treatment costs.
Keywords: Abdominoplasty; Body-contouring; Closed incision negative-pressure therapy; Lipectomy; Mechanical forces; Obesity; Post-bariatric patients; Post-conditioning; Prevena; Surgical site complications; Surgical site infections; Wound care; Wound healing.