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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2025; 60(01): s00451802965
DOI: 10.1055/s-0045-1802965
Artigo Original

Closed-Incision Negative-Pressure Wound Therapy in Proximal and Distal Femur Megaprosthetic Reconstructions after Bone Tumor Resections

Article in several languages: português | English
Joaquim Soares do Brito 
1   Departamento de Ortopedia e Trauma, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria,Lisboa, Portugal
,
Rodrigo Cardoso 
2   Grupo de Oncologia Ortopédica, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, Brasil
3   Grupo de Oncologia Ortopédica, Hospital Universitário Gaffre Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brasil
,
Rodrigo Goes 
1   Departamento de Ortopedia e Trauma, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria,Lisboa, Portugal
,
André Spranger 
1   Departamento de Ortopedia e Trauma, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria,Lisboa, Portugal
,
Paulo Almeida 
1   Departamento de Ortopedia e Trauma, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria,Lisboa, Portugal
,
José Portela 
1   Departamento de Ortopedia e Trauma, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria,Lisboa, Portugal
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Abstract

Objective Surgical management for bone tumors is aggressive in nature and frequently followed by wound-related complications (WRCs). To minimize these events, different strategies have been employed, with closed-incision negative-pressure wound therapy (ciNPWT) emerging as a potential adjuvant. With this study we intend to assess the impact of this technique in minimizing WRCs in patients with proximal and distal femur tumors treated with megaprosthesis.

Methods This was an observational retrospective study including 41 participants diagnosed with proximal or distal femur tumors treated with wide resection and reconstruction using a megaprosthesis. Patients were divided into two groups based on the postoperative surgical dressing applied: the vacuum-assisted closure group (VAC) received ciNPWT; and the non-VAC group that received conventional dressings. Data regarding postoperative WRCs and other potential variables of interest were recorded. Statistical analysis was carried out using the IBM SPSS Statistics, version 24.0.

Results There were 20 patients included in the VAC and 21 in the non-VAC group. The majority of patients presented no complications and there were no differences between groups in terms of WRCs, including infection. Nonetheless, wound dehiscence and persistent fluid leakage had a positive correlation with the diagnosis of infection, which all together presented correlation with the need for surgical revision.

Conclusion Despite the absence of statistical significance, ciNPWT seems to help minimize wound dehiscence, persistent wound leakage and surgical site infections in patients with proximal and distal femur bone tumors treated with megaprosthesis. Also, wound dehiscence and persistent wound leakage correlate well with surgical site infection, and those three parameters correlate with the need for surgical revision.

Keywords

negative-pressure wound therapy - neoplasms - prosthesis - sarcoma - surgical wound infection

Authors' Contributions

JSB contributed to study conception and design, data analysis and interpretation, writing, and tables organization. All the remaining authors also made substantial contributions to study conception, data analysis, and revision.


Financial Support

The authors declare that they did not receive financial support from agencies in the public, private or non-profit sectors to conduct the present study.


Work developed at the Department of Orthopedics and Trauma, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.




Publication History

Received: 07 November 2024

Accepted: 09 January 2025

Article published online:
28 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Joaquim Soares do Brito, Rodrigo Cardoso, Rodrigo Goes, André Spranger, Paulo Almeida, José Portela. Terapia de pressão negativa com a ferida encerrada em reconstruções do fémur proximal e distal com megapróteses após ressecções de tumores ósseos. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451802965.
DOI: 10.1055/s-0045-1802965
 

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