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. 2017 May 31:11:502-507.
doi: 10.2174/1874325001711010502. eCollection 2017.

Negative Pressure Wound Therapy for Closed Surgical Wounds in Musculoskeletal Oncology Patients - A Case-Control Trial

Roderick Kong  1 , David Shields  1 , Oliver Bailey  1 , Sanjay Gupta  1 , Ashish Mahendra  1
Affiliations

Negative Pressure Wound Therapy for Closed Surgical Wounds in Musculoskeletal Oncology Patients - A Case-Control Trial

Roderick Kong et al. Open Orthop J. .

Abstract

Following excision of musculoskeletal tumours, patients are at high risk of wound issues such as infection, dehiscence and delayed healing. This is due to a multitude of factors including the invasive nature of the disease, extensive soft tissue dissection, disruption to blood and lymphatic drainage, residual cavity and adjuvant therapies. The use of negative pressure wound therapy (NPWT) has a growing body of evidence on its beneficial effect of wound healing such as promoting cell differentiation, minimising oedema and thermoregulation. Traditionally, these dressings have been used for open or dehisced wounds; however recent research has investigated its role in closed wounds.

Aim: To evaluate the effect of NPWT in patients with closed wounds, either primarily or with flap coverage, in our high risk group. Consecutive patients who had a NPWT dressing applied were selected, and a control group was established by a blinded researcher with matching for tissue diagnosis, surgical site, gender and age. The primary outcome measured was documented for wound complications, with secondary data collected on radiotherapy and wound drainage.

Results: Patients were well matched between the intervention (n=9) and control (n=9) groups for gender, age and tissue diagnosis. Both groups had 1 patient who underwent preoperative radiotherapy. A total of 3 wound infections occurred in the control group and none in the NPWT group. Overall there was a trend towards lower drain output and statistically significantly reduced infection rate in the NPWT group.

Conclusion: In this short series, despite the NPWT patients having more additional risk factors for wound issues, they resulted in fewer infections. The sample size is not sufficient to have statistically significant reduction. Further evaluation on the value of NPWT in this patient group should be prospectively evaluated.

Keywords: Dressings; Infection; Negative pressure; Sarcoma; Surgical site infection; Wound.

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Figures

Fig. (1)
Fig. (1)
Table showing the demographic of the study group.
Fig. (2)
Fig. (2)
Table showing the distribution of factors which can influence wound healing.
See this image and copyright information in PMC

References

    1. Grimer R, Judson I, Peake D, Seddon B. Guidelines for the Management of Soft Tissue Sarcomas, Sarcoma. 2010;2010:15. doi: 10.1155/2010/506182. 506182. - DOI - PMC - PubMed
    1. Enneking W.F., Spanier S.S., Malawer M.M. The effect of the Anatomic setting on the results of surgical procedures for soft parts sarcoma of the thigh. Cancer. 1981;47(5):1005–1022. doi: 10.1002/1097-0142(19810301)47:5<1005::AID-CNCR2820470532>3.0.CO;2-9. - DOI - PubMed
    1. Chmell Ml, Schwartz HS. Analysis of variables affecting wound healing after musculoskeletal sarcoma resections. 1 SurgOncol. 1996;61:185–189. - PubMed
    1. Peat B.G., Bell R.S., Davis A., OSullivan B., Mahoney J., Manktelow R.T., Bowen V., Catton C., Fornasier V.L., Langer F. Wound-healing complications after soft-tissue sarcoma surgery. Plast. Reconstr. Surg. 1994;93(5):980–987. doi: 10.1097/00006534-199404001-00012. - DOI - PubMed
    1. Payne W.G., Naidu D.K., Wheeler C.K., Barkoe D., Mentis M., Salas R.E., Smith D.J., Jr, Robson M.C. Wound healing in patients with cancer. Eplasty. 2008;8:e9. - PMC - PubMed

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