title: Early mobilization after ilio-inguinal lymph node dissection for melanoma does not increase the wound complication rate.
abstract: OBJECTIVE
  Ilio-inguinal lymph node dissection for stage III melanoma is accompanied by a substantial amount of wound complications. Our treatment protocols changed in time in terms of postoperative bed rest prescriptions, being in chronological order Group A: 10 days with a Bohler Braun splint, Group B: 10 days without splint, and Group C: 5 days without splint. The aim of this study was to evaluate the effect of bed rest prescriptions on wound complications.
  
  
  METHODS
  For this study, we included all patients who underwent ilio-inguinal dissection for stage III melanoma in the period 1989-2011. Both univariate and multivariable analysis were performed to identify factors that were associated with occurrence of wound complications defined as wound infection, wound necrosis, and seroma.
  
  
  RESULTS
  Of the 204 patients analyzed, 99 suffered one or more wound complications: 51 wound infection, 29 wound necrosis, and 39 seroma. A wound complication occurred in 26 out of 64, 51 out of 89, and 22 out of 51 patients for Group A, B, and C, respectively. Univariate analysis showed age >55 (p = 0.001) and presence of comorbidity (p = 0.002) to be associated with higher incidence of wound complications. The 5 day bed rest protocol used in group C did not significantly increase the incidence of wound complications (ref = Group A: OR = 1.18; 95%CI = 0.52-2.68, p = 0.698).
  
  
  CONCLUSIONS
  Early mobilization did not significantly increase the overall wound complication rate after ilio-inguinal lymph node dissection for melanoma. Age >55 and comorbidity were risk factors in univariate analysis.
authors.affiliation: Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: K P
authors.initials: KP
authors.lastname: Wevers
authors.forename: H P A M
authors.initials: HP
authors.lastname: Poos
authors.forename: R J
authors.initials: RJ
authors.lastname: van Ginkel
authors.forename: B
authors.initials: B
authors.lastname: van Etten
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001510:Bed Rest; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004434:Early Ambulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007264:Inguinal Canal / Q000473:pathology / Q000601:surgery; D007902:Length of Stay; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009336:Necrosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D009367:Neoplasm Staging; D055656:Prescriptions; D012189:Retrospective Studies; D012307:Risk Factors; D049291:Seroma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013165:Splints / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome