Negative pressure surgical management after pathological scar surgical excision: a first report

Daniele Bollero, Valeria Malvasio, Fabio Catalano, Maurizio Stella, Daniele Bollero, Valeria Malvasio, Fabio Catalano, Maurizio Stella

Abstract

Wound dehiscence is a surgical complication caused by the application of opposing and distracting forces tending to pull apart the suture line. In recent years, a novel negative pressure surgical management system has been developed to prevent surgical wound complications. This system creates a closed environment that removes exudates and other potentially infectious material, protects the surgical site from external contamination, provides support in holding the edges of the incision together and promotes wound healing. In this study, we describe our first experience with Prevena™, a closed incision negative pressure management system used on suture line following wide pathological scars excision for the prevention of postoperative wound dehiscence. Eight patients with wide and mature pathological skin scars were treated with Prevena™. The device was positioned directly after surgical correction for 8 days with a continuous application of -125 mmHg negative pressure. All treated patients had no postoperative surgical wound dehiscence. In one case, a limit of the device was represented by its poor adherence on hairy surface, hampering the maintenance of an appropriate local negative pressure. In another case, suture line was longer than Prevena™ foam and it was covered partially. Prevena™ system appears to be safe, easy to use and may represent a support technique to wide pathological skin scars surgical correction.

Keywords: Negative pressure wound therapy; Prevena; Scar; Wound healing.

© 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Case 1: (A) Preoperative scar, (B) soft tissue expansion, (C) linear suture after scar excision and (D) Prevena™ application.
Figure 2
Figure 2
Case 1: (A) Scar at Prevena™ removal – 8th day and (B) scar at 12‐month follow‐up.
Figure 3
Figure 3
Absorption property of Prevena™ foam.
Figure 4
Figure 4
Partial coverage of linear incision by Prevena™ system.

Source: PubMed

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