The Plastic Surgery Expert Meeting, hosted recently by Smith & Nephew in Paris, brought together more than 160 European experts in plastic and onco-plastic surgery to discuss the latest evidence-based practice data around the use of PICO in the prevention of incisional complications following breast surgery.
“It is very important to bring some of the most experienced and innovative surgeons together at meetings such as this; to share firsthand ideas which you cannot get from reading a journal article or attending large scientific conferences,” states Professor Laurent Lantieri, Chief of the Department of Plastics and Reconstruction surgery, European Hospital Georges Pompidou, Paris, who chaired the meeting, in a media release from Smith & Nephew.
Incisional complications and delayed healing are not uncommon following breast surgery and can cause avoidable hospital readmissions or increased lengths of stay, which has implications for both the healthcare system and patient outcomes. Delayed healing is a particular issue in post mastectomy reconstruction where the risk of a surgical complication has been found to be four times higher than in non-oncology breast surgery and where any delay to adjunctive treatment such as radiotherapy is to be avoided, the release explains.
“Preventing a wound complication following a mastectomy or lumpectomy is crucial. Even a minor complication can delay radiotherapy or chemotherapy, and can potentially have devastating consequences. Predictable wound healing is vital for this reason but to also save the patient from experiencing psychological distress if treatment is postponed,” says Jennifer Rusby, Consultant Oncoplastic Surgeon, Royal Marsden, London, UK, during the meeting.
Key issues were raised regarding wound care and postoperative issues following breast reduction surgery, including scar quality. Attendees discussed a multicentre-study involving 200 bilateral breast reduction patients during the meeting, which showed significantly fewer wound healing complications for PICO compared to standard care (p=0.004), and a 38% relative reduction in surgical dehiscence by day 21 (a surgical complication in which the wound ruptures along the surgical suture line) from 52 patients (26.4%) to 32 patients (16.2%) (p<0.001). The study also evaluated the scar quality at 42 and 90 days postsurgery. PICO showed significantly better scar quality at each time point (p<0.001), the release explains.
A significantly higher rate of clinical complications, including surgical site infections following breast surgery, tended to occur among patients with a high BMI, the attendees suggest, further noting the possible impact on not only clinical and aesthetic outcomes, but also on the hospital’s resources due to readmissions and further surgery or postoperative care.
“A complication following any kind of breast surgery has implications not just financially, but also to the hospitals and surgeons’ reputations, and we have a duty to our patients to minimise risk and get the best possible patient outcome,” states Hanne Birke Sørenson, plastic and reconstructive surgeon, Aleris-Hamlet Hospital Denmark.
“Collective data presented at this meeting around the use of PICO as a prophylactic use in high-risk patients undergoing breast reduction surgery have demonstrated where the device can reduce complications but also improve cosmetic outcomes. PICO is definitely part of the avoidance of wound complications in the future,” Birke Sørenson continues.
The Plastic Surgery Expert Meeting is one of six such meetings hosted by global medical technology business Smith & Nephew in 2016. Upcoming meetings will discuss challenging wounds (November 10-11) and cardiothoracic and vascular surgery (November 25-26).
[Source: Smith & Nephew]