With an ageing population and a growing number of people with
obesity and/or undergoing advanced
cancer therapies, there is an increasing risk of surgical site complications including
surgical site infections (SSIs). Postoperative shifting of large mobilised tissue flaps, such as in
abdominoplasties, remains a dreaded complication, particularly following massive
weight loss. Besides negative implications for the patient, surgical site complications result in an economic burden due to prolonged and repeated
wound treatments. Preventative tools to reduce SSIs are needed. In selected patients at high risk of SSI and/or
wound breakdown, use of incisional NPWT has been shown to actively manage clean, closed
surgical incisions. This article contains a review of scientific and clinical research relevant to incisional NPWT use over
surgical incisions, with particular emphasis on the common problem of
wound breakdown and SSI following
body-contouring surgery in post-bariatric patients. Although there are a growing number of studies describing use of incisional NPWT in a variety of applications, including vascular, cardiac and orthopaedic, a literature search revealed few studies regarding incisional NPWT use post
body-contouring surgery. In a clinical study of
seroma formation, less
seroma and haematoma formation was reported in post-bariatric patients who received incisional NPWT, versus the control, following
body-contouring surgery. In another study of widely applied external NPWT
wound dressings over the ventral and lateral trunk following post-bariatric abdominal dermolipectomy, results showed a significant reduction in exudate formation, earlier drain removal, and decreased length of hospitalisation, compared with conventional treatment. Additional controlled studies are needed to validate the clinical impact of incisional NPWT following
body-contouring surgery, and to determine proper recommendations for its use.