Limb-sparing surgery is the standard of care for primary bone tumors. However, such procedures are associated with high rates of wound complications, specifically in lower-extremity surgeries. Therefore, identifying and implementing interventions to minimize the likelihood of wound complications after limb-sparing resection of the lower extremity is crucial. Patients who underwent limb-sparing osteosarcoma or Ewing sarcoma resection during a 7-year period at a single institution were retrospectively reviewed. Data were collected on 39 patients who underwent limb-sparing resection of the femur. Patient demographics, tumor characteristics, and perioperative and postoperative data were extracted and analyzed. Patients who underwent resection before April 2017 received conventional postoperative incision dressings. Starting in April 2017, patients received vacuum-assisted closure (VAC) with the 3 M™ Prevena VAC system after surgical closure. Eighteen patients received conventional postoperative incision dressing, and 21 received incisional wound VAC. A wound complication was defined as any Clavien-Dindo classification greater than 0 within a 28-day postoperative period. Patients who received postoperative incisional wound VAC had lower rates of wound complications than those who received conventional incision dressings (14% 50%; p = 0.035). Additionally, patients in whom wound complications developed had a longer average hospital stay than those without wound complications (5 days 4 days; p = 0.029). Wound complications prolong the hospital stay and can delay adjuvant chemotherapy for bone tumors. The use of postoperative incisional wound VAC is associated with less likelihood of wound complications and should be considered in any high-risk surgical closure. Level III Treatment Study.

中文翻译：

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使用真空辅助闭合来降低小儿股骨原发性骨肉瘤保肢切除术后伤口并发症的可能性

保肢手术是原发性骨肿瘤的标准治疗方法。然而，此类手术与伤口并发症的高发生率相关，特别是在下肢手术中。因此，确定并实施干预措施以尽量减少下肢保肢切除术后伤口并发症的可能性至关重要。对 7 年期间在同一机构接受保肢骨肉瘤或尤文肉瘤切除术的患者进行回顾性分析。收集了 39 名接受股骨保肢切除术的患者的数据。提取并分析患者人口统计学、肿瘤特征以及围手术期和术后数据。 2017年4月之前接受手术切除的患者接受常规术后切口敷料。从 2017 年 4 月开始，患者在手术闭合后接受使用 3 M™ Prevena VAC 系统的真空辅助闭合 (VAC)。 18 名患者接受常规术后切口敷料，21 名患者接受切口伤口 VAC。伤口并发症定义为术后 28 天内任何大于 0 的 Clavien-Dindo 分类。接受术后切口伤口 VAC 的患者伤口并发症发生率低于接受传统切口敷料的患者（14% 50%；p = 0.035）。此外，出现伤口并发症的患者比没有伤口并发症的患者平均住院时间更长（5 天×4 天；p = 0.029）。伤口并发症会延长住院时间，并可能延迟骨肿瘤的辅助化疗。使用术后切口伤口 VAC 与伤口并发症的可能性较小有关，在任何高风险手术闭合中都应考虑使用。 III 级治疗研究。