Evaluation of vacuum-assisted closure in patients with wound complications following tumour surgery

Covering the reconstructed area with a healthy soft-tissue envelope is a major challenge after limb-sparing surgery in patients with malignant bone and soft-tissue tumours. Negative pressure wound therapy (NPWT) of open wounds hastens healing and minimises the requirement for complex reconstructive soft-tissue surgery. The aim of this study was to investigate the effectiveness and safety of NPWT in bone and soft-tissue malignant tumour patients with postoperative wound complications. Between January 2006 and November 2009, at a single institution, 13 patients with malignant bone and soft-tissue tumours who had undergone wide resection were retrospectively analysed. NPWT was performed in all patients to temporarily close the soft-tissue defects. After obtaining the culture negativity and normal infection markers, definitive soft-tissue reconstruction was performed to close the wound with primary suturisation in two patients, split thickness grafts in four patients, full thickness grafts in two patients, rotational flaps in three patients and free flaps in two patients. Mean duration of hospitalisation was 20 (range 8-48) days and mean follow-up period was 57·3 (range 50-74) months. There was no tumour recurrence or skip metastasis in the follow-up period. In addition, there was no periprosthetic infection or complication associated with NPWT. In conclusion, NPWT therapy seems to be a safe and effective option in the management of local wound problems and secondary surgical site infections after musculoskeletal tumour surgery.