title: Use of negative pressure wound therapy on malignant wounds - a case report and review of literature.
abstract: The presence of malignancy is considered a contraindication to the use of negative pressure wound therapy (NPWT) because of concerns that it may promote tumourigenesis and expedite metastasis. This notion is extrapolated from studies evaluating NPWT in normal tissues. Despite the absence of direct evidence, the use of this technology in malignant wounds is widely considered a contraindication. We present the case of a patient with treatment-resistant metastatic colon cancer, who developed a chronic abdominal wound with positive margins. A staged reconstruction using NPWT was performed and wound closure allowed the patient to meet eligibility criteria and enrol in a clinical trial for treatment of his oncological disease. Skin closure remained intact until the patient expired 6 months after the wound closure. This case, as well as others in the literature, demonstrated that the use of NPWT should not be considered an absolute contraindication in malignancy. Individualised approaches taking into account the patient's clinical scenario, the available evidence, as well as the risks and benefits of this technology are recommended.
authors.affiliation: Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cai
authors.affiliation: Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Arvind U
authors.initials: AU
authors.lastname: Gowda
authors.affiliation: Division of Surgical Oncology, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Alexander
authors.affiliation: Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Silverman
authors.affiliation: Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Nelson H
authors.initials: NH
authors.lastname: Goldberg
authors.affiliation: Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Rasko
mesh_terms: D000007:Abdominal Injuries / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D003110:Colonic Neoplasms / Q000150:complications* / Q000401:mortality*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D009362:Neoplasm Metastasis; D014945:Wound Healing / Q000502:physiology*
keywords: malignancy; malignant wound; negative pressure wound therapy; vacuum-assisted closure; wound closure