Plastic Surgery Research Council
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PSRC 60th Annual Meeting

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Prevention Of Seroma And Post-operative Wound Complications Using Negative Pressure Wound Therapy Devices Following Panniculectomy In Massive Weight-loss Patients
Marc E. Walker, MD, MBA1, Victor Z. Zhu, BA1, Matthew L. Webb, AB1, Tracy Sturrock, MSN, NP-C1, Reuben Ng, BSc, MSc2, J Grant Thomson, MD1, P Niclas Broer, MD1, Stephanie L. Kwei, MD1.
1Yale University School of Medicine, New Haven, CT, USA, 2Yale University School of Public Health, New Haven, CT, USA.

Purpose:
To compare the immediate application of continuous negative pressure wound therapy (NPWT) versus standard, closed-suction drains (CS) in prevention of seroma in body-contouring patients.
Methods:
In a prospective, randomized-controlled, single-surgeon study, patients seeking panniculectomy were randomized to NPWT or CS drains. Patients were compared on multiple demographic criteria including age, gender, BMI, incision length, pannus weight, nutritional status, comorbidities, prior surgery and duration of drain placement. Abdominal ultrasound was performed 2 weeks following drain removal to objectively quantify persistent fluid collections. Statistical analysis using T-test and logistic regression was performed.
Results:
The NPWT (n=12) and CS (n=10) groups showed no statistically significant differences in age (p=0.407), BMI (p=0.151), incision length (p=0.528), pannus weight (p=0.743), smoking status (p=0.594), diabetes (p=0.293), nutritional status (p>0.05), history of prior surgeries (p=0.378), or drain duration (p=0.429). Both BMI (r=0.679, p=0.001) and pannus weight (r=0.536, p=0.010) showed strong positive correlations with presence of seroma. No significant correlations were identified between age, incision length, and drain duration and presence of seroma (p>0.05). Following drain removal, the mean fluid volumes on ultrasound were 44.6cm3 (0-166) and 11.2cm3 (0-45) for CS and NPWT, respectively. There is a statistically significant difference is seroma presence in CS vs NPWT groups (p=0.037). Controlling for age, BMI, incision length, and drain duration, NPWT drain systems confer a 96.7% risk reduction in seroma presence when compared to standard, closed-suction drains in panniculectomy patients.
Conclusions:
Negative pressure wound therapy drain systems reduce the risk of seroma presence in panniculectomy patients compared to standard, closed suction bulb drains. Increases in BMI and increases in pannus weight correlate with increases in presence of seroma formation. Continuous negative pressure wound therapy connected directly to drains may impact the post-operative outcomes in massive weight loss patients undergoing panniculectomy and other body-contouring procedures.


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