Closed-Incision Negative-Pressure Wound Therapy after Resection of Soft-Tissue Tumors Reduces Wound Complications: Results of a Randomized Trial

Dadras, Mehran; Ufton, Dominic; Sogorski, Alexander; Wallner, Christoph; Wagner, Johannes Maximilian; Lehnhardt, Marcus; Harati, Kamran; Behr, Björn

doi:10.1097/prs.0000000000009023

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…88 Intraoperatively, laser angiography has been used with some preliminary positive results for its use in predicting wound healing, 89 while prophylactic antibiotics were associated with reduced major wound complications when including anaerobic coverage. 90 Postoperatively, recent publications 91 and current trials (NCT04960332 and NCT05944913) are currently exploring incisional NPWT. As preoperative RT has gained more preference with many sarcoma centers and guidelines, more strategies should be developed to minimize wound and infectious complications.…”

Section: Mitigating Complications Associated With Rtmentioning

confidence: 99%

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas

Walker,

Simister,

Carr‐Ascher

et al. 2023

Journal of Surgical Oncology

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In this special edition update on soft tissue sarcomas (STS), we cover classifications, emerging technologies, prognostic tools, radiation schemas, and treatment disparities in extremity and truncal STS. We discuss the importance of enhancing local control and reducing complications, including the role of innovative imaging, surgical guidance, and hypofractionated radiation. We review advancements in systemic and immunotherapeutic treatments and introduce disparities seen in this vulnerable population that must be considered to improve overall patient care.

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Section: Mitigating Complications Associated With Rtmentioning

confidence: 99%

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas

Walker,

Simister,

Carr‐Ascher

et al. 2023

Journal of Surgical Oncology

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“…Recent arthroplasty literature has challenged these practices and found no significant differences in rates of SSI, wound complications, or hematoma formation with the use of postoperative drains [9][10][11] . The use of incisional or wound NPWT has been studied in a modest number of patients treated for sarcomas and has demonstrated a decreased risk of wound complications without an increased risk of local recurrence, but the associations with SSI have not been well described [12][13][14] .…”

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confidence: 99%

Does the Use of Negative Pressure Wound Therapy and Postoperative Drains Impact the Development of Surgical Site Infections?

LiBrizzi

Sabharwal

Forsberg

et al. 2023

Journal of Bone and Joint Surgery

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Background: Surgical site infections (SSIs) represent a major complication following oncologic reconstructions. Our objectives were (1) to assess whether the use of postoperative drains and/or negative pressure wound therapy (NPWT) were associated with SSIs following lower-extremity oncologic reconstruction and (2) to identify factors associated with the duration of postoperative drains and with the duration of NPWT. Methods: This is a secondary analysis of the Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) trial, a multi-institution randomized controlled trial of lower-extremity oncologic reconstructions. Data were recorded regarding the use of drains alone, NPWT alone, or both NPWT and drains, including the total duration of each postoperatively. We analyzed postoperative drain duration and associations with tourniquet use, intraoperative thromboprophylaxis or antifibrinolytic use, incision length, resection length, and total operative time, through use of a linear regression model. A Cox proportional hazards model was used to evaluate the independent predictors of SSI. Results: Overall, 604 patients were included and the incidence of SSI was 15.9%. Postoperative drains alone were used in 409 patients (67.7%), NPWT alone was used in 15 patients (2.5%), and both postoperative drains and NPWT were used in 68 patients (11.3%). The median (and interquartile range [IQR]) duration of drains and of NPWT was 3 days (IQR, 2 to 5 days) and 6 days (IQR, 4 to 8 days), respectively. The use of postoperative drains alone, NPWT alone, or both drains and NPWT was not associated with SSI (p = 0.14). Increased postoperative drain duration was associated with longer operative times and no intraoperative tourniquet use, as shown on linear regression analysis (p < 0.001 and p = 0.03, respectively). A postoperative drain duration of ≥14 days (hazard ratio [HR], 3.6; 95% confidence interval [CI], 1.3 to 9.6; p = 0.01) and an operative time of ≥8 hours (HR, 4.5; 95% CI, 1.7 to 11.9; p = 0.002) were independent predictors of SSI following lower-extremity oncologic reconstruction. Conclusions: A postoperative drain duration of ≥14 days and an operative time of ≥8 hours were independent predictors of SSI following lower-extremity oncologic reconstruction. Neither the use of postoperative drains nor the use of NPWT was a predictor of SSI. Future research is required to delineate the association of the combined use of postoperative drains and NPWT with SSI. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

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Negative-Pressure Wound Therapy: What We Know and What We Need to Know

Yamashiro

Kubota

Mayumi

et al. 2023

Advances in Experimental Medicine and Biology

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Closed-Incision Negative-Pressure Wound Therapy after Resection of Soft-Tissue Tumors Reduces Wound Complications: Results of a Randomized Trial

Cited by 4 publications

References 40 publications

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas

Does the Use of Negative Pressure Wound Therapy and Postoperative Drains Impact the Development of Surgical Site Infections?

Negative-Pressure Wound Therapy: What We Know and What We Need to Know

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