Prophylactic Incisional Negative Pressure Wound Therapy shows promising results in prevention of wound complications following Inguinal Lymph Node Dissection for Melanoma: A retrospective case-control series

Prophylactic Incisional Negative Pressure Wound Therapy shows promising results in prevention of wound complications following Inguinal Lymph Node Dissection for Melanoma: A retrospective case-control series:

Publication date: Available online 2 March 2019

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Mads Gustaf Jørgensen, Navid Mohamadpour Toyserkani, Jørn Bo Thomsen, Jens Ahm Sørensen

Abstract

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 has 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 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 prevention of lymphedema (35.7% vs 51.2%, p = 0.33). Due to the iNPWT group having relatively fewer incidences of seroma SSI and lymphedema, the iNPWT intervention was more cost-effective than conventional wound care (911.2US$ vs 2542.7US$, p<0.05).

Conclusion

The use of Prophylactic iNPWT significantly reduced seroma formation following ILND. These promising results, however, needs to be confirmed in a future prospective randomized trial.