Commentary on: “Usefulness of Incisional Negative Pressure Wound Therapy for Decreasing Wound Complication Rates and Seroma Formation Following Prepectoral Breast Reconstruction”

Abstract

Dear Editor, We have read with great interest, the article entitled ‘‘Usefulness of Incisional Negative Pressure Wound Therapy for Decreasing Wound Complication Rates and Seroma Formation Following Prepectoral Breast Reconstruction’’ by Ryu et al. [1] published in Aesthetic Plastic Surgery. The authors found a significant benefit using a 1-time negative pressure wound therapy (NPWT) dressing after prepectoral breast reconstruction for reducing the frequency of complications and major seroma, as well as the duration and total incidences of seroma. We aim to strengthen the findings of the authors with our personal experience with NPWT and prepectoral breast reconstructions. Indeed, we applied NPWT to twelve patients that underwent monolateral skin-reducing mastectomies (SRM) and prepectoral direct-to-implant (DTI) breast reconstructions (BR) with the help of either humanderived acellular dermal matrix (HD-ADM) or de-epithelized dermal graft taken from the contralateral breast while performing a matching reducing mammaplasty [2, 3]. Wound break-down and flaps necrosis at the inverted-T junction are the most common and feared complications of DTI-BR following SRM by being responsible for up to 40% of implant losses [4]. Furthermore, one of the main issues with the use of acellular dermal matrixes (ADMs) is the high risk for seroma formation and high drainage output [5]. The NPWT device that we employed was Prevena Peel&Place (Kinetic Concepts Inc., San Antonio, TX),