Recently published studies have demonstrated clinical effectiveness of closed-incision negative-pressure therapy in many fields of surgery including vascular, cardiac, colorectal, orthopedic, and reconstructive surgery. A review of current literature is conduct to determine whether the application of negative-pressure therapy to closed incisions post aesthetic procedures was beneficial.
The PubMed/MEDLINE databases are search for preclinical and clinical studies publish through June 2018. Higher quality publications that met the following criteria were included: adult patients undergoing aesthetic or body contouring procedures, comparison of ciNPT with conventional dressings, and documentation of wound complications and/or incision quality.
One animal and multiple small, retrospective comparison articles are discuss. Scientific mechanism of action and economic analysis are also discuss. There are no level 1 randomiz prospective controll trials that directly evaluate the effects of ciNPT dressings in cosmetic patients.
For patients undergoing certain cosmetic procedures, preliminary data support the idea that ciNPT dressings provide aesthetic benefit; but more research is clearly needed.Incision quality after surgery; especially in aesthetic surgery, is important to patient and physician alike.
Managing these incisions to yield the best appearing results requires a multi factorial approach. Contributing factors include tension, melanin, and inflammation. Some factors are modifiable such as reducing inflammation through gentle tissue handling, decreasing thermal energy spread, and/or proper suture selection; other issues such as melanin content cannot be altered.
Because it relates to the modulation of tension across the suture line, the concept of closed-incision negative-pressure therapy has recently been recognized. Since 2006, there has been increasing evidence supporting the use of these dressings; which especially may help to reduce wound complications such as infection. The aim of this article is to review the evidence regarding foam-based ciNPT dressings such as PREVENA Incision Management System (Acelity; San Antonio, TX) specifically in aesthetic surgery patients.
Foam-base ciNPT dressings are typically applly in an operating room under sterile conditions. They ideally remain intact over the suture line for days postoperative. Not only does the dressing keep a cleaner protected wound healing environment for a longer duration than standard gauze; but it also helps to maintain stronger tissue approximation.
Furthermore; an important computer modeling study has predicted significant reduction in lateral skin tension in the area directly under the foam dressing. The question then arises; does this known reduction in tension for 5–7 days in the immediate postoperative period result in any meaningful downstream clinical finding related to improved incision quality?
One small animal study directly investigated this question. Control and experimental swine groups of 3 are creat; and application of ciNPT dressings compared with gauze translated into significantly improved incisional mechanical properties (ie, strain energy density; peak strain) and a narrower scar in the deep dermis on day 40. This remarkable finding of improved healing has not been reported in prospective randomized controlled investigations with human subjects followed long term.