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European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

10.03.2023 | Original Article

Closed-incision negative-pressure wound therapy (ciNPWT) to minimize wound-related complications in lower limb reconstruction after bone tumor resection: preliminary proof-of-concept study

verfasst von: Joaquim Soares do Brito, Miguel Esperança Martins, Rodrigo Goes, André Spranger, Paulo Almeida, Isabel Fernandes, José Portela

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 7/2023

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Abstract

Aims

The purpose of this study was to compare the impact of postoperative closed-incision negative-pressure wound therapy (ciNPWT) and conventional dressings in wound-related complications after bone tumor resection and reconstruction.

Patients and methods

A total of 50 patients with bone tumors and clinical indication for wide resection and reconstruction were included and divided into two groups (A and B). Bone defect reconstructions were achieved with modular endoprosthesis or biologic techniques, mainly involving allografts with free vascularized fibula. Group A received ciNPWT, and Group B conventional dressings. Wound-related complications, including wound dehiscence, persistent wound leakage, surgical site infections (SSIs), and causes for surgical revision, were assessed.

Results

Nineteen patients were included in Group A and 31 in Group B. No significant differences were found between groups regarding epidemiologic and clinical presentation features, contrarily to reconstructive options, which were significantly different between both (Fisher = 10,100; p = 0.005). Additionally, Group A presented lower wound dehiscence rate (0 vs. 19.4%; χ²₍₁₎ = 4.179; p = 0.041), SSI rate (0 vs. 19.4%; χ²₍₁₎ = 4.179; p = 0.041), and surgical revision rate (5.3% vs. 32.3%; χ²₍₁₎ = 5.003; p = 0.025) compared to Group B.

Conclusions

This is the first study reporting the impact of ciNPWT after bone tumor resection and reconstruction, and its results support a potential role for this technique in diminishing postoperative wound complications and SSIs. A multicentric randomized controlled trial may help clarify the role and impact of ciNPWT after bone tumor resection and reconstruction.

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Titel: Closed-incision negative-pressure wound therapy (ciNPWT) to minimize wound-related complications in lower limb reconstruction after bone tumor resection: preliminary proof-of-concept study
verfasst von: Joaquim Soares do Brito
Miguel Esperança Martins
Rodrigo Goes
André Spranger
Paulo Almeida
Isabel Fernandes
José Portela
Publikationsdatum: 10.03.2023
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 7/2023
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03501-5

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Closed-incision negative-pressure wound therapy (ciNPWT) to minimize wound-related complications in lower limb reconstruction after bone tumor resection: preliminary proof-of-concept study

Abstract