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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

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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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Authors and Affiliations

  1. Department of Orthopedics and Trauma, Centro Hospitalar Universitário Lisboa Norte, 1649-028, Lisbon, Portugal

    Joaquim Soares do Brito, Rodrigo Goes, André Spranger, Paulo Almeida & José Portela

  2. Department of Medical Oncology, Centro Hospitalar Universitário Lisboa Norte, 1649-028, Lisbon, Portugal

    Miguel Esperança Martins & Isabel Fernandes

  3. Translational Oncobiology Laboratory, Instituto de Medicina Molecular – João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028, Lisbon, Portugal

    Miguel Esperança Martins & Isabel Fernandes

Authors
  1. Joaquim Soares do Brito
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  2. Miguel Esperança Martins
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  4. André Spranger
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  5. Paulo Almeida
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Contributions

Joaquim Soares do Brito contributed to study conception and design, data analysis and interpretation, writing, and table organization; all the remaining authors also made substantial contributions to study conception, data analysis and revision.

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Correspondence to Joaquim Soares do Brito.

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Soares do Brito, J., Esperança Martins, M., Goes, R. et al. 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. Eur J Orthop Surg Traumatol 33, 2895–2902 (2023). https://doi.org/10.1007/s00590-023-03501-5

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