Turkish Journal of Plastic Surgery (Jan 2025)

Profilactic VAC Therapy after Inguinal Lymph Node Dissection in Malignant Melanoma

  • İsmail Tekfiliz,
  • Yusuf Berkay Çınar,
  • Can İlker Demir,
  • Emrah Kağan Yaşar,
  • Murat Şahin Alagöz

DOI
https://doi.org/10.4103/tjps.tjps_21_24
Journal volume & issue
Vol. 33, no. 1
pp. 35 – 40

Abstract

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Introduction: Inguinal lymph node dissection is frequently used in the diagnosis and treatment of malignant melanomas. However, postdissection, the high rates of complications have become a significant challenge. Seroma, infections, hematomas, and lymphedema are among the primary complications encountered. This study aims to compare the complications rate of vacuum-assisted closure (VAC) versus conventional dressing in patients undergoing inguinal lymph node dissection. Materials and Methods: Fourteen patients who underwent inguinal lymph node dissection due to malignant melanoma between 2019 and 2022 at our clinic were examined in this study. After dissection, VAC dressing applied to the wound site. VAC was operated at 120 mmHg negative pressure for all patients, switched to intermittent mode 24 h later, and changed every 4 days. Daily drain measurements were recorded for all patients. The remaining seven patients were followed up with conventional dressing without VAC. Daily drain measurements were also recorded for this group. Both groups were regularly monitored for seroma, wound site infection, and hematoma. Results: A total of 14 patients who underwent inguinal lymph node dissection due to malignant melanoma were divided into two groups: Conventionally followed (Group 1) and VAC followed (Group 2). The drainage removal time in patients followed with VAC was an average of 14.7 days while it was 8.3 days in the conventionally followed group. Seroma was observed in three patients in Group 1, whereas it was not observed in Group 2. Wound site infection was not encountered in Group 2, whereas it occurred in two patients in Group 1. Conclusion: Our study suggests that the application of VAC after inguinal lymph node dissection reduces complications such as seroma, wound site detachment, and infection. However, it is important to consider the disadvantages, such as the high cost of materials and prolonged drain removal time, when deciding on postdissection VAC application.

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