Internal Negative Pressure Wound Therapy Device Improves Patient Satisfaction and Reduces Seroma and Return to OR Compared to Standard Bulb Drains Following Breast Surgery

BACKGROUND: Drains are the most common tool employed for the prevention of seroma in breast surgery patients with closed suction bulb reservoirs being the standard for evacuation of fluid from a surgical space. Negative pressure wound therapy (NPWT) utilizes sub-atmospheric pressure to facilitate healing in both acute and chronic wounds. A recent advancement in internalized NPWT (iNPWT) has allowed for the application of continuous negative pressure via drain tubing as an alternative to standard closed suction bulbs to evacuate and collapse the surgical space. This study aimed to identify differences in patient satisfaction, clinically significant seroma, and operative complications between the two devices. METHODS: A retrospective chart review was performed identifying patients who underwent breast surgery at a single center between 2012-2025 and received either a bulb drain (n=44) or internal NPWT device (n=49). Patient demographics, operative details, drain type, postoperative complications, patient satisfaction, and pain on a 10-point Likert scale at final follow-up were collected. All statistical analyses were performed in SPSS. RESULTS: Patients who received an iNPWT device were significantly more satisfied with their experience compared to those who received bulb drains (Likert Scale 9.27 vs 8.05, P=0.008), experienced a significantly lower rate of seroma (0.0% vs 13.6%, P=0.009), and had a significantly lower rate of return to OR (2.0% vs 13.6%, P=0.050). Moreover, among oncologic patients, use of iNPWT was associated with lower clinically significant seroma rates compared with closed suction bulb drains (0% vs 14%, P=0.037). CONCLUSION: Internal NPWT devices have a positive impact on overall patient experience and reduce seroma formation and other operative complications in postoperative breast patients compared to closed suction bulb drains.