Comparison of complication rates in transgender top surgery (female to male) between conventional bandages and negative pressure wound therapy – A retrospective analysis

Fifty to 70 % of transgender patients undergo gender-affirming top surgery. In other types of surgeries, the use of negative pressure wound therapy (NPWT) was described as a major point in reducing complications, and we, therefore, examined possible similar effects when using it in gender-affirming top surgery. We investigated differences in the complication rates after body contouring surgery with or without the use of NPWT and included 58 female-to-male transgender patients who have been operated on at the Medical University of Vienna between 2017 and 2020 in this retrospective analysis. Without NPWT, significantly more patients suffered from wound dehiscence (<i>p</i> = 0.026) and slightly more patients had to undergo postoperative percutaneous drainage due to seroma (<i>p</i> = 0.129). However, patients had significantly less revision surgery because of severe bleeding with the conventional dressing (<i>p</i> = 0.005). The surgical method was another factor influencing the occurrence of wound dehiscence, especially regarding the incision type and the resected volume. Large breasts and the necessity for using a typical mastectomy incision were underlying factors for dehiscence. There are fewer complications when using NPWT, especially regarding wound dehiscence in top surgery; however, postsurgery monitoring is required for severe bleeding afterward.