#NEGATIVE PRESSURE WOUND THERAPY NCBI SERIAL#
#NEGATIVE PRESSURE WOUND THERAPY NCBI SKIN#
#NEGATIVE PRESSURE WOUND THERAPY NCBI TRIAL#

Primary closure was then attempted but failed to produce satisfactory results. During this period, his tumour burden remained stable, but his abdominal wound failed to heal.

Following recovery, the patient received radiation therapy to the abdomen and was treated with regorafenib. NPWT was initially applied but discontinued 2 days after discharge by a local wound care facility. No attempt at definitive resection was undertaken because of the extensive nature of the recurrence and the presence of a significant soft tissue infection in the area. Frozen section returned metastatic adenocarcinoma consistent with the colonic primary. Incision and drainage of the abdominal wall abscess revealed a suspicious mass that appeared to be contiguous with the abscess cavity.

#NEGATIVE PRESSURE WOUND THERAPY NCBI SERIAL#

Adjuvant chemotherapy, including multiple cycles of FOLFOX and FOLFIRI, were administered and serial imaging showed a stable tumour burden.ĭisease recurrence was suspected 30 months later, when the patient presented with periumbilical pain and scant spontaneous purulent drainage from the prior incision site. He subsequently underwent an extensive cytoreductive surgery in May 2012 that included partial gastrectomy, left hemicolectomy with primary anastomosis, distal pancreatectomy, splenectomy and segment III partial hepatectomy. The previously healthy 44‐year‐old man was transferred to our institution for definitive management of T4N0M1 adenocarcinoma of the colon.

#NEGATIVE PRESSURE WOUND THERAPY NCBI SKIN#

Skin closure remained intact for 3 months postoperatively, during which time the patient successfully enrolled in a clinical trial. VERAFLO™ Therapy, KCI, an ACELITY company, San Antonio, TX) and closed incision negative pressure therapy (ciNPT PREVENA™ Incision Management System, KCI, an ACELITY company, San Antonio, TX). Despite the commonly held belief that NPWT is contraindicated in malignant wounds, the senior author closed this patient's abdominal wound by performing a staged reconstruction using two novel types of NPWT: NPWT with instillation of topical wound solutions with a dwell time (NPWTi‐d V.A.C.

#NEGATIVE PRESSURE WOUND THERAPY NCBI TRIAL#

The patient had hoped to enrol in a clinical trial that offered potentially life‐saving treatments however, the presence of a chronic open wound precluded trial enrolment. This belief is derived from studies on normal tissues, and no literature directly supports the hypothesis that NPWT modulates oncological progression.Ī 44‐year‐old man with metastatic colon cancer, which was unresponsive to surgical debulking, multi‐regimen chemotherapy and local radiation, developed a non‐healing abdominal wound with gross tumour association. Despite the broadening clinical usage of NPWT, one prevailing contraindication is its use in malignant wounds because of concerns that NPWT may promote tumourigenesis and expedite metastasis 3. Its clinical applications currently encompass exposed bone or joints, deep sternal wounds, open abdomen or intra‐abdominal infections, as well as ulcers from pressure injury, vascular insufficiency and diabetes 5, 6, 7, 8, 9, 10. Both randomised controlled trials and retrospective cohort studies report benefits such as reduced wound volume, accelerated granulation formation and a lower incidence of postoperative complications including infection, dehiscence and necrosis 1, 2, 3, 4. The therapeutic potential of negative pressure wound therapy (NPWT) is well documented. 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. This case, as well as others in the literature, demonstrated that the use of NPWT should not be considered an absolute contraindication in malignancy. Skin closure remained intact until the patient expired 6 months after the wound closure. 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. We present the case of a patient with treatment‐resistant metastatic colon cancer, who developed a chronic abdominal wound with positive margins. Despite the absence of direct evidence, the use of this technology in malignant wounds is widely considered a contraindication. This notion is extrapolated from studies evaluating NPWT in normal tissues.

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.

Negative pressure wound therapy ncbi