Combined Therapy With Incisional Negative Pressure Wound Therapy and Penrose Drainage for Flap Surgery

Summary: Pressure ulcers are well recognized, yet severe cases often require surgical closure. However, contaminated wounds and external forces from postoperative positioning can lead to high complication rates, prolonging treatment and increasing burdens on patients, providers, and healthcare costs. Negative pressure wound therapy has traditionally been used for chronic ulcers and traumatic wounds, and recent studies underscore the efficacy of incisional negative pressure wound therapy (INPWT) in reducing postoperative complications. Conventional closed suction drains, however, often lose suction pressure with increased drainage volume, risking clot obstruction. We report a case using a combination of INPWT and Penrose drainage on a flap surgical wound to achieve efficient drainage and favorable outcomes. Between April 2020 and September 2021, 4 cases using INPWT postoperatively following pressure ulcer surgery were evaluated. All 4 patients were women with sacral ulcers, with an average age of 70.3 years (range 43–89 y). Comorbidities included diabetes in 1 patient and a smoking history in another. The average healing time was 14 days (range 12–16 d). Postoperative complications—including hematoma, surgical site infection, wound dehiscence, and flap necrosis—pose risks for ulcer recurrence. Effective management is therefore crucial. Combining INPWT with Penrose drainage enhanced drainage efficiency and promoted wound healing, thereby reducing complications and expediting recovery.