Post-malignancy irradiation ulcers with exposed alloplastic materials can be salvaged with topical negative pressure therapy (TNP)

• Published in: European journal of surgical oncology Vol. 33; no. 7; pp. 920 - 925
• Main Authors: Loos, B, Kopp, J, Hohenberger, W, Horch, R.E
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2007
• Subjects: Adult; Aged; Alloplastic material; Cancer; Debridement - methods; Female; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; Humans; Irradiated tissue; Male; Middle Aged; Neoplasms - radiotherapy; Oncologic surgery; Radiation Injuries - etiology; Radiation Injuries - pathology; Radiation Injuries - therapy; Salvage Therapy - methods; Skin Transplantation - methods; Surgery; Surgical Flaps; Surgical Mesh; Topical negative pressure; Ulcer - etiology; Ulcer - pathology; Ulcer - therapy; Vacuum; Wound Healing; Topical negative pressure; Alloplastic material; Irradiated tissue; Oncologic surgery; Cancer
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2006.12.018

Abstract Aim The aim of this study was to salvage or to integrate exposed alloplastic meshes in post malignancy irradiated chronic wounds by using topical negative pressure (TNP) therapy together with staged debridement. Methods Three patients with secondarily exposed alloplastic meshes in irradiated non-healing wounds were treated by serial debridement and repeated topical negative pressure therapy until clean and vital wounds were achieved, followed by ultimate plastic coverage by a myocutaneous flap or split-thickness skin graft. The range of the follow-up period was from 18 to 36 months. Results After staged serial debridement and repeated vacuum treatment periods wounds were preconditioned in an acceptable fashion for ultimate plastic coverage. After the treatment with a myocutaneous flap or split-thickness skin graft all three patients achieved long-term stable wounds with no alloplastic mesh complication within the follow-up period. Conclusion Computer-controlled TNP therapy (vacuum-assisted closure therapy) together with staged debridement can help to induce granulation tissue formation in irradiated wounds and allows integration of alloplastic materials into regenerating wounds after ablative oncologic surgery.