The top concerns for most surgeons today are post-operative complications and infections. Negative pressure therapy promises to help surgeons reduce these risks and their associated costs.
During a September webinar hosted by Becker's Hospital Review and sponsored by 3M, Michael Desvigne, MD, founder of CoolBody Contours, moderated a discussion with Anthony Dardano, DO, chief of plastic surgery trauma at Delray Medical Center in Boca Raton, Fla., and Timothy Alton, MD, of Proliance Orthopedic Associates in Renton, Wash., about their experiences using negative pressure therapy.
Four key takeaways:
- At a time when ASCs are facing increased volumes, standard surgical dressings may not provide the best infection protection. According to Dr. Alton, the number of orthopedic cases performed in an ambulatory setting is expected to increase by 25 percent over the next decade. But with this increase, surgeons continue to worry about post-operative infection. "The dressing is sometimes as important as the surgery underneath," Dr. Dardano said. "An in vitro study showed that bacteria can actually pass through up to 64 layers of dry gauze and if it gets wet, it becomes even less effective."
- Negative pressure therapy provides an optimal healing environment. "The 3M Prevena dressing has now been FDA cleared to specifically reduce the risk of post-operative complications following surgical incisions," Dr. Desvigne said. Incisional negative pressure therapy helps surgeons maintain optimal healing environments by decreasing soft tissue swelling, surgical site infections, edema, pain and scarring.
- The performance of negative pressure therapy has proven itself in both cosmetic and reconstructive cases. Dr. Dardano shared the case of a female undergoing a congenital breast deformity correction. "The closed incision negative pressure system from the Prevena Restor BellaForm has provided me with an excellent option to take care of these patients postoperatively," he said. "Three weeks following surgery, this patient was healing nicely, and at six months, her incisions were barely noticeable."
Dr. Alton experienced similar success with hip and knee replacements. "We really want to decrease the risk of patients having wound healing problems and infections," he said. He shared a case of a patient with many co-morbidities, including osteoarthritis, diabetes and obesity. "We do lot of work beforehand to reduce modifiable risk factors, and negative pressure dressing is one more thing that we can use." After surgery, this patient went home the same day with a negative pressure dressing. She was able to shower the next day and could take off the dressing during a telemedicine visit a week later. "At six weeks, she was perfectly healed and very happy," he said. - Education about benefits and cost avoidance from using negative pressure therapy will be key to widespread adoption. According to a randomized controlled trial by Higuera-Rueda in 2020, when negative pressure therapy was used, patients were 78 percent less likely to experience a surgical site complication after 90 days compared to a standard of care dressing.
This presents cost advantages, as well as patient benefits. Per Dr. Desvigne, data shows that any surgical site infection usually increases the cost of care by about $40,000 per patient. As far as patient adoption, Dr. Dardano explains to patients up front that negative pressure therapy will reduce the number of dressing changes and will be more comfortable. Dr. Alton said his patients are "pretty much on board with anything that decreases infection risk."
With these early successes and recent FDA approval, 3M Prevena Restor BellaForm promises to drastically improve surgical incision healing and reduce costs for high-risk patients.
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