title: Continuous high-pressure negative suction drain: new powerful tool for closed wound management: clinical experience.
abstract: BACKGROUND
  Although various reconstructive flap surgeries have been successfully performed, there still are difficult wound complications, such as seroma formation, wound margin necrosis, delayed wound healing, and even flap failures. The negative-pressure wound therapy has been described in detail in the literature to assist open chronic/complex wound closure in reconstructive surgery. However, the negative-pressure wound therapy was difficult to be applied under the incisional closed wounds.
  
  
  METHODS
  A total of 23 patients underwent the various reconstructive flap surgeries with continuous high-pressure negative suction drain. Instead of using regular suction units, Barovac (50-90 mm Hg, Sewoon Medical, Seoul, Republic of Korea) drainage tubes were connected to the wall suction unit, providing continuous high-powered negative pressure. In addition, continuous subatmospheric suction pressure (100-300 mm Hg) was applied. Outcome of the measures was obtained from the incidence of seroma, volume of postoperative drainage, hospitalization period, and incidence of other typical wound complications. Dead space was evaluated postoperatively with ultrasonography.
  
  
  RESULTS
  Using continuous high-pressure negative suction drain, successful management of seroma was obtained without any major complication such as wound infection, flap loss, and wound margin necrosis, except for only 1 case of seroma after discharge from the hospital. The indwelling time of the drain in the latissimus dorsi donor site was significantly reduced in comparison with the authors' previous data (P = 0.047). The volume of drainage and hospitalization period were also reduced; however, these were not statistically significant. The dead space with continuous high-pressure negative suction drain was more reduced than in the control group in the immediate postoperative period and confirmed with ultrasonography.
  
  
  CONCLUSIONS
  Continuous high-pressure negative suction drain might be the simple and powerful solution in the management of challenging closed wounds.
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon, Republic of Korea.
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Shin
authors.forename: DaeHee
authors.initials: D
authors.lastname: Han
authors.forename: Hyunsuk
authors.initials: H
authors.lastname: Song
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Jang
authors.forename: Dong Ha
authors.initials: DH
authors.lastname: Park
authors.forename: Myong Chul
authors.initials: MC
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation* / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy*; D049291:Seroma / Q000628:therapy*; D013396:Suction / Q000295:instrumentation* / Q000379:methods*; D013524:Surgical Flaps / Q000601:surgery*; D055815:Young Adult