To compare the immediate application of continuous negative pressure wound therapy (NPWT) versus standard, closed-suction drains (JP) in prevention of seroma and post-operative wound complications in morbidly obese body-contouring patients.
Methods/Technique:
In a prospective, randomized-controlled study, patients seeking panniculectomy following massive weight-loss were randomized to NPWT or JP drains. Patients were compared on multiple demographic criteria including age, gender, BMI, length of incision, weight of pannus excised, nutritional status, history of bariatric surgery, and duration of drain placement. Abdominal ultrasound two weeks post-operatively objectively quantified fluid collection. Wound-related complications, including infection and need for re-operation were recorded. All procedures were performed by the same plastic surgeon.
Results/Complications:
The 14 patients (8 NPWT: 6 JP) currently reported in this report (13F:1M) had a mean age of 38 years (24-52), mean BMI of 34 (26-49), and 11 (79%) were within 3 years post-bariatric surgery. The mean incision length was 56 cm (44-78) in the NPWT group and 52 cm (30-60) in the JP group; mean pannus excised was 3148 g (1092-5500) NPWT and 3778 g (1661-5560) JP; mean durations of drain placement were 12.4 days (11-14) NPWT and 12.6 (6-18) JP. Following drain removal, the mean fluid volumes on ultrasound were 35.5 cc (0 – 91.5) NPWT and 117 cc (6.6 – 333) JP. Of note, three of eight NPWT patients were found to have no fluid collections while fluid was noted in all six JP patients (Fisher’s exact, p=0.0014).
Conclusion:
There is an objectively quantified difference in absolute post-operative fluid collection between the NPWT and JP subgroups, suggesting that the immediate application of NPWT drains to the incisional wound of large, body-contouring patients might reduce complication rates and enhance outcomes.
*Data presented in this abstract in its current form is based on a subset of patients currently enrolled in this study all of whom have completed the follow-up period. Several patients are pending completion, after which they will be added as additional data points and presented with the full cohort. The final results of this study will be presented at The Meeting 2013, if accepted.