Improved perioperative seroma and complication rates following the application of a 2-layer negative pressure wound therapy system after inguinal lymphadenectomy for metastatic cutaneous melanoma

Moncrieff, Marc D., Sharma, Riti A., Gathura, Esther and Heaton, Martin J. (2020) Improved perioperative seroma and complication rates following the application of a 2-layer negative pressure wound therapy system after inguinal lymphadenectomy for metastatic cutaneous melanoma. Annals of Surgical Oncology, 27 (10). pp. 3692-3701. ISSN 1068-9265

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Abstract

Background: Perioperative complications following inguinal lymphadenectomy, including seroma formation, are frequent. We have employed a 2-layer negative pressure wound therapy (2-LNPWT) as a method to reduce seroma rate and perioperative complications. We present the outcome of our initial experience with 2-LNPWT and compare the outcomes of its use with traditional closed suction drains (CSDs).  Materials and methods: A non-randomised retrospective case–control series was analysed. Surgeons performing inguinal lymphadenectomy for metastatic cutaneous melanoma utilised either the 2-LNPWT therapy or traditional CSDs according to their practice preference.  Results: The study included 111 patients. The cohorts were well matched for gender, disease burden, body mass index and comorbidities. The 2-LNPWT technique was associated with significantly better postoperative outcomes than CSD, in terms of incidence of seroma formation (26.9% vs 49.4%; p < 0.03), period of drainage (15 days vs 20 days; p = 0.005) and return to theatre rate (0% vs 15.3%; p = 0.03). The overall seroma rate was 44.1%. The only significant association with seroma initiation was the type of drainage system used (2-LNPWT 31.2% vs CSD 58.3%; p < 0.03; OR 3.0). The method of drainage did not alter the course of an established seroma. There was no significant difference in overall or disease-specific survival detected between the 2 groups.  Conclusion: This retrospective non-randomised case control study has demonstrated the safe use of a novel application of negative pressure wound therapy that significantly reduced the incidence of seroma formation and postoperative complication rate for inguinal lymphadenectomy for melanoma.

Item Type:	Article
Uncontrolled Keywords:	surgery,oncology ,/dk/atira/pure/subjectarea/asjc/2700/2746
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	LivePure Connector
Date Deposited:	03 Jul 2021 00:13
Last Modified:	23 Oct 2022 02:35
URI:	https://ueaeprints.uea.ac.uk/id/eprint/80396
DOI:	10.1245/s10434-020-08513-7

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