Use of negative pressure wound therapy on malignant wounds - a case report and review of literature

Int Wound J. 2017 Aug;14(4):661-665. doi: 10.1111/iwj.12665. Epub 2016 Oct 3.

Abstract

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. This notion is extrapolated from studies evaluating NPWT in normal tissues. Despite the absence of direct evidence, the use of this technology in malignant wounds is widely considered a contraindication. We present the case of a patient with treatment-resistant metastatic colon cancer, who developed a chronic abdominal wound with positive margins. 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. Skin closure remained intact until the patient expired 6 months after the wound closure. This case, as well as others in the literature, demonstrated that the use of NPWT should not be considered an absolute contraindication in malignancy. 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.

Keywords: malignancy; malignant wound; negative pressure wound therapy; vacuum-assisted closure; wound closure.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Injuries / etiology*
  • Abdominal Injuries / therapy*
  • Adult
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / mortality*
  • Fatal Outcome
  • Humans
  • Male
  • Negative-Pressure Wound Therapy / methods*
  • Neoplasm Metastasis
  • Wound Healing / physiology*