Vacuum-assisted closure in the treatment of extensive lymphangiomas in children.
BACKGROUND
The management of lymphangiomas in children is a complex problem with frequent recurrence and infection. Vacuum-assisted closure (VAC) devices have been shown to accelerate the healing of open wounds. We hypothesized that VAC therapy might decrease complications after resection of lymphangiomas.


METHODS
A retrospective review was performed on 13 children (August 2005 to April 2010) who were patients undergoing lymphangioma resection with postoperative VAC therapy. Patient demographics, size and location of the lymphangioma, VAC duration and number of changes, hospital stay, complications, need for further surgery, and length of follow-up were recorded.


RESULTS
Thirteen children (mean age, 8 years; mean weight, 34 kg) underwent 15 operations for lymphangiomas followed by postoperative VAC therapy. Locations included the head and neck, thorax and abdomen, and lower extremity. The mean VAC duration was 19 days, and they underwent a mean of 2.6 VAC changes. Six children had operative closure of the wound at a mean of 15 days postoperative. The remaining patients underwent closure by secondary intention. There were no recurrences. Complications included VAC device malfunctions requiring intervention and wound infections. Mean follow-up was 289 days.


CONCLUSIONS
Postoperative VAC therapy for the treatment of lymphangiomas can be an effective adjunct to surgical treatment by decreasing risks of recurrence and infection.
Department of Pediatric General, Thoracic and Minimally Invasive Surgery, St. Christopher's Hospital for Children/Drexel University College of Medicine, Philadelphia, PA 19134, USA.
Michael S
MS
Katz
Christine M
CM
Finck
Marshall Z
MZ
Schwartz
Matthew L
ML
Moront
Rajeev
R
Prasad
Shaheen J
SJ
Timmapuri
L Grier
LG
Arthur
D000008:Abdominal Neoplasms / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007223:Infant; D007866:Leg / Q000601:surgery; D008202:Lymphangioma / Q000601:surgery*; D018191:Lymphangioma, Cystic / Q000601:surgery; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation / Q000706:statistics & numerical data; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000601:surgery*; D055815:Young Adult