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The Final Touch: Impact Of Post-operative Dressings On Reduction Mammoplasty
Steven Zeng, MD, Thomas Ren, BA, Ricardo Rodriguez, MD, Nina Ringelman, PA, Salman Choudhry, MD, Gedge Rosson, MD, David Cooney, MD.
Johns Hopkins Hospital, Baltimore, MD, USA.
PURPOSE: Optimal wound dressing following reduction mammoplasty has not been established. We compare post-operative outcomes across commonly used dressings.
METHODS: A single-institution review was performed of patients undergoing reduction mammoplasty from 2023-2025. Data collected included demographics, operative details, dressing type, and complications. Dressings included Dermabond, Dermabond Prineo, Histacryl, Sylke, Steri-Strips, and combinations. Complications included reoperation, skin reaction, hematoma/seroma, dehiscence, infection, antibiotics, nipple necrosis, and scarring. Statistical analyses included t-tests, chi-squared, and logistic regression.
RESULTS:A total of 250 patients (439 breasts) were identified. Most received Histacryl (38%) or Sylke (35%). Cohorts differed significantly in BMI, ASA, diabetes, operative time, and resection volume, due to higher comorbidities and longer operative times among Prineo patients. When excluded, there were no demographic or operative differences among the remaining cohorts. Univariate analysis demonstrated Prineo had higher rates of complications, including skin reactions, dehiscence, reoperation, and scarring (Table 1). When Prineo was excluded, Histacryl had increased skin reactions than the Sylke (p=0.0029) and combination cohorts (p=0.049) and increased dehiscence than Sylke (p=0.043).On multivariate analysis, Sylke predicted descreased skin reaction (OR=0.2, 95%CI=[0.06,0.54]) and dehiscence (OR=0.47, 95%CI=[0.25,0.88]). Prineo predicted increased reoperation (OR=6.4), 95%CI=[1.5,28.5]) and scarring (OR=34.8, 95%CI=[6.1, 252.9]).
CONCLUSION:Prineo was associated with worse outcomes (skin reaction, dehiscence, poor scarring, and reoperation). Histacryl demonstrated increased skin reaction and dehiscence, while Sylke appeared protective. Further studies are needed to evaluate Dermabond and Steri-Strips.
| Dressing | Skin Reaction (%) | p-value | Dehiscence (%) | p-value | Reoperation (%) | p-value | Poor Scarring (%) | p-value |
| Prineo | 36 | | 45 | | 36 | | 50 | |
| Sylke | 3 | 0.0001 | 13 | 0.001 | 3 | 0.0001 | 2 | 0.0001 |
| Dermabond | 4 | 0.007 | 8 | 0.01 | 4 | 0.002 | 0 | 0.0001 |
| Histacryl | 13 | 0.01 | 22 | 0.03 | 8 | 0.007 | 4 | 0.0001 |
| Steri-Strips | 13 | NS | 17 | NS | 4 | 0.008 | 4 | 0.001 |
| Combination | 2 | 0.0002 | 14 | 0.007 | 6 | 0.0007 | 0 | 0.0001 |
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