What is the influence of negative pressure wound therapy on high-risk wounds in pelvic oncology?

Abstract

Introduction: & Aims: Hindquarter amputation (HQA) has a high incidence of post-operative wound complications. We aim to use the HQA procedure as a model to investigate the potential advantages of negative pressure wound therapy (NPWT) on wound healing complications in high-risk pelvic oncology wounds. Methods: We conducted a retrospective analysis of all patients undergoing HQA between January 2009 and November 2020 ​at a single tertiary centre. 106 patients underwent HQA for sarcoma. 43.4% (46 patients) had NPWT therapy following HQA. We compared the incidence of wound complications necessitating a return to the operating theatre, total incidence of wound infection (according to CDC Surgical site infection guidelines) and local recurrence between patients with and without NPWT. Results: In the absence of neo-adjuvant radiotherapy, there was no difference in the incidence of wound complications requiring re-operation between the NPWT group and the conventional dressing group (odds ratio [OR], 1.01; p ​= ​0.983, 95% confidence interval [CI], 0.365–2.8). However, the use of NPWT decreased the incidence of reoperation after neo-adjuvant radiotherapy versus conventional dressings [OR], 0.087; p ​= ​0.033, 95% CI, 0.009–0.818). The incidence of wound infection has declined with the increasing use of NPWT between 2009 and 2020. There was no difference in the incidence of local recurrence after two years between patient groups with and without NPWT. Conclusion: The application of NPWT reduces the incidence of wound complications in high-risk pelvic oncology wounds after neo-adjuvant radiotherapy. We demonstrated a reduction in the incidence of reoperation due to wound complications in patients who received NPWT following HQA.

Keywords

• Vacuum-assisted closure
• Wound complications
• Hindquarter amputation
• Negative pressure wound therapy
• Oncology