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Online ISSN 1827-1707
Boffano M. 1, Brach del Prever E. M. 1, Stella M. 2, Bollero D. 2, Capocelli R. 2, Albertini U. 1, Piana R. 1, Linari A. 3, Mosetto F. 1, Sacco F. 1, Gino G. 1
1 Dipartimento di Ortopedia e Traumatologia Unità Operativa Dipartimentale di Chirurgia Ortopedica Oncologica e Ricostruttiva
ASO CTO, CRF, MA di Torino, Torino
2 Struttura Complessa di Chirurgia Plastica-Ricostruttiva e Grandi Ustionati ASO CTO, CRF MA di Torino, Torino
3 Servizio di Anatomia Patologica ASO OIRM S. ANNA di Torino, Torino
Aim. Treatment of soft tissue sarcomas with conservative surgical approach and limb salvage increases the risk of surgical wound complications. Negative pressure therapy (VAC®), suggested in the treatment of wound complications, could induce proliferation in ulcerated neoplasms. Aim of the study was to evaluate soft tissue sarcomas with local complications of the wound treated with VAC® therapy after surgical resection.
Methods. From January 2003 to June 2005 at the Departmental Unit of Orthopaedic-Oncological and Reconstructive Surgery of ASO CTO, CRF, MA in Turin, 87 cases of soft tissue sarcomas were treated. In 6 patients, after en bloc resection with wide margins in 4 cases and partially marginal in 2 cases, VAC® therapy was used for flap complications (2 cases), for wound dehiscence (3 cases), for necrotizing fascitis (1 case). Application time, local evolution of the wound, local recurrence and progression, Mankin’s functionality and follow up were analyzed.
Results. Mean application time was 41.5 days. In 5 cases wound healing has been obtained, 1 patient died during the treatment for general complications. 1 progression and 1 local recurrence occurred. Functionality is in 1 case Excellent, in 1 case Fair, in 3 cases Failure. Follow-up outcomes are: 4 patients with no evidence of disease, 1 dead of disease.
Conclusion. VAC® therapy approach in soft tissue sarcomas is suggested in few selected cases; it positively influences wound healing, it could be used after en bloc surgical resection with adequate margins.