Use of negative-pressure wound therapy in breast tissues: evaluation of the literature.

BACKGROUND: Negative-pressure wound therapy (NPWT) has been suggetsed to have a positive impact on the healing of sternal or extremity wounds. However, few data deriving from breast surgery have been published. We evaluated the available literature regarding the effectiveness of NPWT systems in the healing of breast tissues.
METHODS: The PubMed and Scopus databases were searched systematically, and all studies that provided relevant data were considered eligible for inclusion in the review. Twenty studies (154 female patients) met the inclusion criteria (four cohort studies, one case series, and 15 case reports).
RESULTS: The NPWT system was used alone in 17 patients and in combination with other techniques in the remaining 137. The lesion was secondary to plastic surgery in 107 women, other operations in 40 women (38 of them for breast cancer), and primary breast infection in seven women. Infections (including necrotizing fasciitis), pyoderma gangrenosum, and necrosis were among the most common complications for which NPWT was used. In total, 150 of 154 patients receiving NPWT healed completely. Two patients died before complete closure for reasons unrelated to the wound, and NPWT failed in two patients who healed later with muscle flap coverage.
CONCLUSION: The scant published evidence suggests that NPWT systems might be useful in the healing of complicated breast wounds. However, larger studies are needed to investigate the effectiveness of this system further before it is established in breast surgery.