Surgical-site infection following lymph node excision indicates susceptibility for lymphedema: A retrospective cohort study of malignant melanoma patients

Jørgensen, Mads Gustaf; Toyserkani, Navid Mohamadpour; Thomsen, Jørn Bo; Sørensen, Jens Ahm

doi:10.1016/j.bjps.2017.11.026

Cited by 24 publications

(20 citation statements)

References 31 publications

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“…Hence, the 2x10Gy model is a Refinement of previous works, in that no serious morbidity was observed and allows for lymphedema to be consistently quantifiable with a Reduced number of animals [33]. While the described mouse model shares many of the key clinical lymphedema characteristics, the etiology of the condition is different to the long-term onset seen in humans [34]. As rodents primarily heal by contraction and humans by reepithelization [35], no lymphedema rodent model can resemble the human condition perfectly.…”

Section: Discussionmentioning

confidence: 96%

Quantification of Chronic Lymphedema in a Revised Mouse Model

Jørgensen¹,

Toyserkani²,

Hansen³

et al. 2018

Annals of Plastic Surgery

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Section: Discussionmentioning

confidence: 96%

Quantification of Chronic Lymphedema in a Revised Mouse Model

Jørgensen¹,

Toyserkani²,

Hansen³

et al. 2018

Annals of Plastic Surgery

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“…One of the most common postoperative complications in the perioperative period is seroma. 1,10,11 There have been multiple studies that have investigated interventions designed to either reduce the incidence or reduce the extent of the problem once it has become established. [12][13][14][15] A recent systematic review by the Cochrane Group 11 identified a lack of any useful data and concluded that, ''…there is a need for high quality RCTs to guide clinical practice in this under-researched area.''…”

Section: Discussionmentioning

confidence: 99%

“…However, studies have shown an associated increase in lymphoedema with postoperative surgical site infection. 10 , 15 It is advocated that any future randomised study should include lymphoedema as an endpoint. Finally, it is worth commenting that the median length of stay was 8 days for both cohorts.…”

Section: Discussionmentioning

confidence: 99%

Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma

et al. 2020

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Background. Perioperative complications following inguinal lymphadenectomy, including seroma formation, are frequent. We have employed a 2-layer negative pressure wound therapy (2-LNPWT) as a method to reduce seroma rate and perioperative complications. We present the outcome of our initial experience with 2-LNPWT and compare the outcomes of its use with traditional closed suction drains (CSDs). Materials and methods. A non-randomised retrospective case-control series was analysed. Surgeons performing inguinal lymphadenectomy for metastatic cutaneous melanoma utilised either the 2-LNPWT therapy or traditional CSDs according to their practice preference. Results. The study included 111 patients. The cohorts were well matched for gender, disease burden, body mass index and comorbidities. The 2-LNPWT technique was associated with significantly better postoperative outcomes than CSD, in terms of incidence of seroma formation (26.9% vs 49.4%; p \ 0.03), period of drainage (15 days vs 20 days; p = 0.005) and return to theatre rate (0% vs 15.3%; p = 0.03). The overall seroma rate was 44.1%. The only significant association with seroma initiation was the type of drainage system used (2-LNPWT 31.2% vs CSD 58.3%; p \ 0.03; OR 3.0). The method of drainage did not alter the course of an established seroma. There was no significant difference in overall or disease-specific survival detected between the 2 groups. Conclusion. This retrospective non-randomised case control study has demonstrated the safe use of a novel application of negative pressure wound therapy that significantly reduced the incidence of seroma formation and postoperative complication rate for inguinal lymphadenectomy for melanoma.

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“…Surgical resection of malignant melanoma that has metastasized must also be accompanied with complete lymph node dissection. However, there is a marked increase in risk of lymphedema due to a cascade of postoperative events (Jørgensen et al, 2018). Systemic adjuvant therapy, especially targeted combination therapy, might offer significant advantages in the treatment of melanoma.…”

Section: Introductionmentioning

confidence: 99%

Anti-Melanoma Activities of Artemisone and Prenylated Amino-Artemisinins in Combination With Known Anticancer Drugs

et al. 2020

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The most frequently occurring cancers are those of the skin, with melanoma being the leading cause of death due to skin cancer. Breakthroughs in chemotherapy have been achieved in certain cases, though only marginal advances have been made in treatment of metastatic melanoma. Strategies aimed at inducing redox dysregulation by use of reactive oxygen species (ROS) inducers present a promising approach to cancer chemotherapy. Here we use a rational combination of an oxidant drug combined with a redox or prooxidant drug to optimize the cytotoxic effect. Thus we demonstrate for the first time enhanced activity of the amino-artemisinin artemisone and novel prenylated piperazine derivatives derived from dihydroartemisinin as the oxidant component, and elesclomol-Cu (II) as the redox component, against human malignant melanoma cells A375 in vitro. The combinations caused a dose dependent decrease in cell numbers and increase in apoptosis. The results indicate that oxidant-redox drug combinations have considerable potential and warrant further investigation.

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Surgical-site infection following lymph node excision indicates susceptibility for lymphedema: A retrospective cohort study of malignant melanoma patients

Abstract: SSI was the greatest independent risk factor for developing lymphedema. Additionally, patients' that developed postoperative seroma were at an increased risk of also developing SSI. Future studies should examine if lymphedema can be prevented, by reducing seroma and SSI.

Cited by 24 publications

References 31 publications

Quantification of Chronic Lymphedema in a Revised Mouse Model

Quantification of Chronic Lymphedema in a Revised Mouse Model

Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma

Anti-Melanoma Activities of Artemisone and Prenylated Amino-Artemisinins in Combination With Known Anticancer Drugs

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