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Wound Complications after Inguinal Lymph Node Dissection for Melanoma: Is ACS NSQIP Adequate?

  • Melanomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

In the treatment of melanoma, inguinal lymph node dissection (ILND) is the standard of care for palpable or biopsy-proven lymph node metastases. Wound complications occur frequently after ILND. In the current study, the multicenter American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) was utilized to examine the frequency and predictors of wound complications after ILND.

Methods

Patients with cutaneous melanoma who underwent superficial and superficial with deep ILND from 2005-2010 were selected from the ACS NSQIP database. Standard ACS NSQIP 30-day outcome variables for wound occurrences—superficial surgical site infection (SSI), deep SSI, organ space SSI, and disruption—were defined as wound complications.

Results

Of 281 total patients, only 14 % of patients had wound complications, a rate much lower than those reported in previous single institution studies. In a multivariable model, superficial with deep ILND, obesity, and diabetes were significantly associated with wound complications. There was no difference in the rate of reoperation in patients with and without wound complications.

Conclusions

ACS NSQIP appears to markedly underreport the actual incidence of wound complications after ILND. This may reflect the program’s narrow definition of wound occurrences, which does not include seroma, hematoma, lymph leak, and skin necrosis. Future iterations of the ACS NSQIP for Oncology and procedure-specific modules should expand the definition of wound occurrences to incorporate these clinically relevant complications.

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Disclaimer

The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in it represent the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or for the conclusions derived by the authors.

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Authors and Affiliations

  1. Department of Surgery, University of Wisconsin, Madison, WI, USA

    Carly E. Glarner MD, David Y. Greenblatt MD, MSPH, Robert J. Rettammel MA, Heather B. Neuman MD, MPH & Sharon M. Weber MD, FACS

Authors
  1. Carly E. Glarner MD
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  2. David Y. Greenblatt MD, MSPH
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  3. Robert J. Rettammel MA
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  4. Heather B. Neuman MD, MPH
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  5. Sharon M. Weber MD, FACS
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Corresponding author

Correspondence to Sharon M. Weber MD, FACS.

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Glarner, C.E., Greenblatt, D.Y., Rettammel, R.J. et al. Wound Complications after Inguinal Lymph Node Dissection for Melanoma: Is ACS NSQIP Adequate?. Ann Surg Oncol 20, 2049–2055 (2013). https://doi.org/10.1245/s10434-012-2856-7

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  • DOI: https://doi.org/10.1245/s10434-012-2856-7

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