Solving "T" Junction Wound Breakdown With a Single Tension-reducing Device.

Abstract

Wound complications at the inverted "T" junction of a Wise pattern scar after breast reduction are common. These are minor complications of delayed healing that rarely require surgical revision. Nonetheless, these are problematic for patients and their surgeons, often resulting in additional encounters related to the care of the unhealed area. In this single-surgeon study, a tension-reducing device was added to the standard incisional closure regimen, and incisional healing was evaluated 6 weeks postoperatively by the surgeon. Two groups of 17 patients who underwent Wise pattern bilateral breast reduction were compared. Group 1 (retrospective historical control group) underwent standard dermal and intracutaneous absorbable suture closure, and Group 2 (prospective experimental group) underwent standard absorbable layered closure plus the intraoperative application of a single tension-reducing device placed transversely on the skin, 3 cm above the inframammary incision, crossing and supporting the vertical scar. Unlike a standard skin tape, the tension-reducing device has a Velcro-like bridge connecting the 2 sides, allowing the application of compression to the vertical incision. The device was left in place for 6 weeks. Dermabond and Steri-Strips were also used equivalently in both groups. At 6 weeks, 22 of 34 of the T areas healed in the standard closure group. The tension-reducing device group healed in 34 of 34 of the T areas (<i>P</i> < 0.002, Fisher exact test). The standard closure group required 13 additional patient encounters (office visits, telemedicine, etc.). The addition of a tension-reducing device significantly improved the 6-week incisional healing outcomes.