Advertisement

pp 1-6 | Cite as

Use of Negative-Pressure Wound Therapy on Malignant Wounds

  • Yvonne M. Rasko
  • Stephen S. Cai
  • Silviu C. Diaconu
Chapter
Part of the Recent Clinical Techniques, Results, and Research in Wounds book series

Abstract

The use of negative-pressure wound therapy (NPWT) is traditionally contraindicated in malignant wounds due to concerns that it may promote tumorigenesis and expedite metastasis. However this belief is largely derived from studies on normal tissue and no literature directly supports the hypothesis that NPWT modulates oncological progression. Several studies reported the use of this technology in malignancy for palliative purposes with satisfactory outcome. Most recently, our own experience demonstrated successful closure of malignant wounds with the assistance of NPWT and no overt tumor progression on follow-up. These cases, as well as others in the literature, demonstrated that use of NPWT should not be considered an absolute contraindication in malignancy. Individualized approaches taking into account the patient’s clinical scenario, the available evidence, as well as the risks and benefits of this technology are recommended.

References

  1. 1.
    Naylor W (2002) Malignant wounds: aetiology and principles of management. Nurs Stand 16:45–53Google Scholar
  2. 2.
    Grocott P (2007) Care of patients with fungating malignant wounds. Nurs Stand 21:57–58, 60, 62Google Scholar
  3. 3.
    Fromantin I, Watson S, Baffie A, Rivat A, Falcou M-C, Kriegel I, de Rycke Ingenior Y (2014) A prospective, descriptive cohort study of malignant wound characteristics and wound care strategies in patients with breast cancer. Ostomy Wound Manage 60:38–48Google Scholar
  4. 4.
    Trent JT, Kirsner RS (2003) Wounds and malignancy. Adv Skin Wound Care 16:31–34Google Scholar
  5. 5.
    Lookingbill DP, Spangler N, Helm KF (1993) Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 29:228–236Google Scholar
  6. 6.
    Probst S, Arber A, Faithfull S (2009) Malignant fungating wounds: A survey of nurses’ clinical practice in Switzerland. Eur J Oncol Nurs 13:295–298Google Scholar
  7. 7.
    Huang C, Leavitt T, Bayer LR, Orgill DP (2014) Effect of negative pressure wound therapy on wound healing. Curr Probl Surg 51:301–331Google Scholar
  8. 8.
    Ford-Dunn S (2006) Use of vacuum assisted closure therapy in the palliation of a malignant wound. Palliat Med 20:477–478Google Scholar
  9. 9.
    Riot S, de Bonnecaze G, Garrido I, Ferron G, Grolleau J-L, Chaput B (2015) Is the use of negative pressure wound therapy for a malignant wound legitimate in a palliative context? ‘The concept of NPWT ad vitam’: A case series. Palliat Med 29:470–473Google Scholar
  10. 10.
    Kim PJ, Attinger CE, Steinberg JS, Evans KK, Lehner B, Willy C, Lavery L, Wolvos T, Orgill D, Ennis W, Lantis J, Gabriel A, Schultz G (2013) Negative-pressure wound therapy with instillation: international consensus guidelines. Plast Reconstr Surg 132:1569–1579Google Scholar
  11. 11.
    Back DA, Scheuermann-Poley C, Willy C (2013) Recommendations on negative pressure wound therapy with instillation and antimicrobial solutions - when, where and how to use: what does the evidence show? Int Wound J 10:32–42Google Scholar
  12. 12.
    Blackham AU, Farrah JP, McCoy TP, Schmidt BS, Shen P (2013) Prevention of surgical site infections in high-risk patients with laparotomy incisions using negative-pressure therapy. Am J Surg 205:647–654Google Scholar
  13. 13.
    Karlakki S, Brem M, Giannini S, Khanduja V, Stannard J, Martin R (2013) Negative pressure wound therapy for managementof the surgical incision in orthopaedic surgery: A review of evidence and mechanisms for an emerging indication. Bone Jt Res 2:276–284Google Scholar
  14. 14.
    Atkins BZ, Tetterton JK, Petersen RP, Hurley K, Wolfe WG (2011) Laser Doppler flowmetry assessment of peristernal perfusion after cardiac surgery: beneficial effect of negative pressure therapy. Int Wound J 8:56–62Google Scholar
  15. 15.
    Erba P, Ogawa R, Ackermann M, Adini A, Miele LF, Dastouri P, Helm D, Mentzer SJ, D’Amato RJ, Murphy GF, Konerding MA, Orgill DP (2011) Angiogenesis in wounds treated by microdeformational wound therapy. Ann Surg 253:402–409Google Scholar
  16. 16.
    Wackenfors A, Sjögren J, Gustafsson R, Algotsson L, Ingemansson R, Malmsjö M (2004) Effects of vacuum-assisted closure therapy on inguinal wound edge microvascular blood flow. Wound Repair Regen 12(6):600Google Scholar
  17. 17.
    Ingber DE (2004) The mechanochemical basis of cell and tissue regulation. Mech Chem Biosyst 1:53–68Google Scholar
  18. 18.
    Ingber DE, Huang S (1999) The structural and mechanical complexity of cell-growth control. Nat Cell Biol 1:E131–E1E8Google Scholar
  19. 19.
    Gouin J-P, Kiecolt-Glaser JK (2011) The impact of psychological stress on wound healing: methods and mechanisms. Immunol Allergy Clin North Am 31:81–93Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Yvonne M. Rasko
    • 1
  • Stephen S. Cai
    • 1
  • Silviu C. Diaconu
    • 2
  1. 1.Department of Plastic SurgeryUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreUSA

Personalised recommendations