Effect of Vacuum Assisted Closure System on Wound Healing Duration in Parastomal Wounds: A Retrospective Study
Introduction: In cancer patients, wound healing is seriously impaired due to cachexia and tumour-related catabolism. Therefore, several surgical complications may develop in patients with malignant diagnosis. Parastomal wounds are also among the most frequent surgical complications in this patie...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/13859/44399_CE[Ra1]_F(KM)_PF1(Chr_SL)_PFA(RV_SL)_PN(SL).pdf |
| Summary: | Introduction: In cancer patients, wound healing is seriously
impaired due to cachexia and tumour-related catabolism.
Therefore, several surgical complications may develop in
patients with malignant diagnosis. Parastomal wounds are also
among the most frequent surgical complications in this patient
group which causes serious deterioration of the patients’ quality
of life. Various factors influence the duration of parastomal
wound healing and multiple methods are used in its treatment.
Among them, new method is the treatment with the VacuumAssisted Closure (VAC) system.
Aim: To examine the effect of VAC system on the duration of
wound healing in parastomal wounds.
Materials and Methods: A retrospective study was conducted
in which the data of 31 patients who underwent surgery with
a diagnosis of intra-abdominal malignancy at the surgical
oncology clinic between January 2010 to January 2018,
and who developed a parastomal wound were evaluated
retrospectively, through the hospital database. The patients’
clinical and demographic data, peristomal skin complications
and the applied treatment methods were determined from the
hospital database. The effect of the patient-related factors
and the VAC treatment on the duration of wound healing was
analysed. The patients whose data could not be accessed and
had no stoma complications were excluded from the study. In
this study, analyses were performed using IBM SPSS statistical
version 23.0.
Results: A total of 38 patients developed parastomal wounds. The
seven patients whose data could not be accessed were excluded
from the study, so 31 patients who developed parastomal
wounds, participated and out of them 10 (32.2%) were men and
the mean age was found as 51.77±15.23. There were 20 patients
with ileostomy and 11 patients with colostomy. The most frequent
diagnosis in the patient population was colorectal cancer. The
VAC treatment was applied to 14 (45.2%) of the patients, the
others were applied conventional wound care methods. When
the relationship between clinical, demographic data, parastomal
wound treatment methods and the durations of wound healing
were viewed, the effect of being above 65 years of age (p=0.044),
presence of Diabetes mellitus (DM) (p=0.012), and having a Body
Mass Index (BMI) value of 25 or above (p=0.046) on parastomal
wound healing was found to be statistically significant. Parastomal
wound healing took a longer time in these patients. When the VAC
treatment and other conventional wound treatment methods were
compared, the duration of hospital stay was found to be short,
statistically and significantly, in the VAC group (p=0.016).
Conclusion: In malignant patients, being above the age of 65,
the presence of DM and having a BMI value of 25 and above
lengthen the duration of parastomal wound healing. The healing
duration in parastomal wounds treated with VAC is shorter than
other conventional methods. Thus, VAC is a successful and
feasible method in parastomal wound treatment. Although, the
results of this retrospective study are helpful in predicting and
managing parastomal wounds, but prospective, randomised and
large-scale studies are needed. |
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| ISSN: | 2249-782X 0973-709X |