At a recent meeting hosted by Smith & Nephew in Paris, over 160 European experts in plastic and onco-plastic surgery met to discuss new data and share the latest evidenced-based best practice around the use of PICO, a novel single use negative pressure wound therapy (NPWT), in the prevention of incisional complications following breast surgery.
Incisional complications and delayed healing are not uncommon following breast surgery and can cause avoidable hospital readmissions or increased lengths of stay, which has implications for the health care system and patient outcomes. Delayed healing is a particular issue in post mastectomy reconstruction where the risk of a surgical complication has been found to be four times higher than in non-oncology breast surgery, and where any delay to adjunctive treatment such as radiotherapy is to be avoided.
With regards to breast reduction surgery, other key issues were raised with regards to wound care and post operative issues including scar quality. A multicenter-study involving 200 bilateral breast reduction patients was presented to delegates, which showed significantly fewer wound healing complications for PICO compared to standard care (p=0.004), and a 38 percent relative reduction in surgical dehiscence by day 21 (a surgical complication in which the wound ruptures along the surgical suture line) from 52 patients (26.4 percent) to 32 patients (16.2 percent) (p<0.001). The study also evaluated the scar quality at 42 and 90 days post surgery. PICO showed significantly better scar quality at each time point (p<0.001).
Clinical complications including surgical site infections following breast surgery were also identified as significantly higher amongst patients with a high BMI, impacting on both clinical and aesthetic outcomes, but also on the hospital’s resources due to re-admissions and further surgery or post-operative care.
The Plastic Surgery Expert Meeting hosted by Smith & Nephew is one of a series of six meetings happening during 2016, including the use of NPWT across specialties such as orthopedic and obstetrics and gynecology. •