Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy

• Published in: Plastic and reconstructive surgery. Global open Vol. 10; no. 3; p. e4171
• Main Authors: Deldar, Romina, Abu El Hawa, Areeg A, Bovill, John D, Hipolito, Dionisio, Tefera, Eshetu, Bhanot, Parag, Fan, Kenneth L, Evans, Karen K
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01.03.2022; Wolters Kluwer
• Subjects: Original; Reconstructive
• ISSN: 2169-7574; 2169-7574
• DOI: 10.1097/GOX.0000000000004171

Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether ciNPWT is effective at preventing complications in VHR-PAN. The aim of our study was to evaluate if ciNPWT improves outcomes of VHR-PAN. A retrospective review of patients who underwent VHR-PAN between 2009 and 2021 was conducted. Patients were divided into two groups: (1) those who received standard sterile dressings (SSD), or (2) ciNPWT. Primary outcomes were postoperative complications, including surgical site occurrences (SSO) and hernia recurrence. A total of 114 patients were identified: 57 patients each in the SSD group and ciNPWT group. The groups were similar in demographics and comorbidities. There were more smokers in the SSD group (22.8% versus 5.3%, = 0.013). Hernia defect size was significantly larger in patients who received ciNPWT (202.0 versus 143.4 cm , = 0.010). Overall SSO was similar between the two groups (23.2% versus 26.3%, = 0.663). At a mean follow-up of 6.6 months, hernia recurrence rate was significantly higher in the SSD group compared with that in the ciNPWT group. (10.5% versus 0%, = 0.027). Smoking, diabetes, component separation, mesh type, and location were not significantly associated with hernia recurrence. Application of incisional NPWT is beneficial in decreasing hernia recurrence in VHR-PAN, compared with standard dressings. Larger prospective studies are warranted to further elucidate the utility of ciNPWT in abdominal wall reconstruction.