Vacuum-assisted wound closure after resection of musculoskeletal tumors.
Resection of musculoskeletal tumors may result in large soft tissue defects that cannot be closed primarily and require prolonged dressing changes and complex surgical interventions for wound coverage. We retrospectively reviewed 23 patients with such defects treated with a vacuum-assisted wound closure system and compared the outcome of these patients with a control group. The study group included 15 women and eight men who had their wounds located at the back (two), pelvic girdle (11), thigh (eight), and leg (two). Treatment included sealed wound coverage with polyurethane foam and overlying tape connected to a vacuum pump. This system was disconnected and changed every 48 hours for 7 to 19 days, after which all defects were reduced in size by an average of 25% and covered with a viable granulation tissue. This allowed primary closure in seven patients, primary closure with skin grafting in 14 patients, and healing by secondary intention in two patients. Compared with the control group, patients in the study group had shorter hospital stays and number of surgical interventions and greater rates of primary wound closure. The use of vacuum-assisted wound closure facilitates wound healing and primary wound closure in patients who have a large soft tissue defect after resection of a musculoskeletal tumor.


METHODS
Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.
Bickels
Jacob
J
National Unit of Orthopedic Oncology and Department of Oncology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. jbickels@012.net.il
Kollender
Yehuda
Y
Wittig
James C
JC
Cohen
Nir
N
Meller
Isaac
I
Malawer
Martin M
MM
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002813:Chondrosarcoma / Q000601:surgery; D002817:Chordoma / Q000601:surgery*; D003646:Debridement; D005260:Female; D006097:Granulation Tissue; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery*; D012878:Skin Neoplasms / Q000556:secondary; D013514:Surgical Procedures, Operative / Q000379:methods; D014619:Vacuum Curettage / Q000379:methods*; D014945:Wound Healing