TY - JOUR
T1 - Prophylactic incisional negative pressure wound therapy shows promising results in prevention of wound complications following inguinal lymph node dissection for Melanoma
T2 - A retrospective case-control series
AU - Jørgensen, Mads Gustaf
AU - Toyserkani, Navid Mohamadpour
AU - Thomsen, Jørn Bo
AU - Sørensen, Jens Ahm
N1 - Copyright � 2019 Elsevier Ltd. All rights reserved.
PY - 2019/7
Y1 - 2019/7
N2 - BACKGROUND: Inguinal lymphadenectomy (ILND) for melanoma is associated with a number of complications including seroma, surgical site infection (SSI), and lymphedema. Incisional negative pressure wound therapy (iNPWT) has shown promising results in preventing postoperative morbidity across a wide variety of surgical procedures, but these results are yet to be investigated in patients undergoing ILND for melanoma.METHODS: In this study, we reviewed the data of 55 melanoma patients treated with ILND between January 2015 and January 2017 at Odense University Hospital. Patients were followed up until April 2018 for the occurrence of seroma, SSI, and lymphedema. We used prophylactic iNPWT after ILND in 14 patients and compared their morbidity outcomes with the 41 patients receiving standard postoperative wound care in the same period.RESULTS: The iNPWT intervention significantly reduced seroma compared to the control group (28.6% vs. 90.3%, p < 0.001) and had a trending impact on wound infection (42.9% vs. 65.9%, p?=?0.13). The effect was not significant for the prevention of lymphedema (35.7% vs. 51.2%, p?=?0.33). Because the iNPWT group had relatively fewer incidences of seroma, SSI, and lymphedema, the iNPWT intervention was more cost-effective than conventional wound care (US$911.2?vs. US$2542.7, p < 0.05).CONCLUSION: The use of prophylactic iNPWT significantly reduced seroma formation following ILND. These promising results, however, need to be confirmed in a future prospective randomized trial.
AB - BACKGROUND: Inguinal lymphadenectomy (ILND) for melanoma is associated with a number of complications including seroma, surgical site infection (SSI), and lymphedema. Incisional negative pressure wound therapy (iNPWT) has shown promising results in preventing postoperative morbidity across a wide variety of surgical procedures, but these results are yet to be investigated in patients undergoing ILND for melanoma.METHODS: In this study, we reviewed the data of 55 melanoma patients treated with ILND between January 2015 and January 2017 at Odense University Hospital. Patients were followed up until April 2018 for the occurrence of seroma, SSI, and lymphedema. We used prophylactic iNPWT after ILND in 14 patients and compared their morbidity outcomes with the 41 patients receiving standard postoperative wound care in the same period.RESULTS: The iNPWT intervention significantly reduced seroma compared to the control group (28.6% vs. 90.3%, p < 0.001) and had a trending impact on wound infection (42.9% vs. 65.9%, p?=?0.13). The effect was not significant for the prevention of lymphedema (35.7% vs. 51.2%, p?=?0.33). Because the iNPWT group had relatively fewer incidences of seroma, SSI, and lymphedema, the iNPWT intervention was more cost-effective than conventional wound care (US$911.2?vs. US$2542.7, p < 0.05).CONCLUSION: The use of prophylactic iNPWT significantly reduced seroma formation following ILND. These promising results, however, need to be confirmed in a future prospective randomized trial.
U2 - 10.1016/j.bjps.2019.02.013
DO - 10.1016/j.bjps.2019.02.013
M3 - Article
C2 - 30898502
SN - 1748-6815
VL - 72
SP - 1178
EP - 1183
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
IS - 7
ER -