The use of VAC therapy for wound healing in sarcoma surgery: A comprehensive analysis of high-risk patient populations and VAC therapy
Claeys Emma, Decreton Laure, 2025
The tissues of the body around the bones, joints, and organs – such as muscles, fat, tendons, and arteries – are called soft tissues. A malignant tumor originating from these tissues is called a soft tissue sarcoma. It is a rare type of cancer that often presents as a growing painless lump that can grow remarkably before diagnosis. Next to radiotherapy and/or chemotherapy, part of the treatment may consist of surgically removing the tumor. However, complications can occur on the remaining wound requiring more additional interventions and care for the patient.
In response to this challenge, closed incision negative pressure wound therapy recently emerged as an innovative technique that has already been used in different fields of surgery to reduce the occurrence of wound problems. The therapy consists of an airtight dressing applied to the wound, connected to a vacuum pump. This device creates a negative pressure between the wound edges, hereby pulling them together. It is proven to help the wound heal quicker while reducing the need for constant dressing changes. However, it is not yet the standard of care.
The theoretical background of the impact of factors such as sex, age, presence of diabetes and/or obesity, substance use, radiotherapy and/or chemotherapy, and the tumor's histological grade and location were first examined. These factors were then analyzed in a patient population with wound complications following surgery for soft tissue sarcoma. Data from 65 patients was examined. Most patients were over 60 years old, and many had significant health conditions that could affect healing. For instance, many were either overweight or had comorbidities, which are linked to poor wound healing. Substance use was also prevalent, with over half of the patients reporting alcohol or nicotine use, both of which can negatively affect recovery.
Tumor characteristics such as size and location, were highlighted as relevant factors for wound healing. Radiotherapy, before and after surgery, was another important factor due to its impact on tissue health and healing. High-grade tumors, which are more aggressive, were found in a large number of patients, requiring more intensive treatment, which further complicated the healing process.
Overall, factors such as older age, comorbidities, obesity, smoking, alcohol use, and aggressive tumor characteristics all contribute to a higher risk of wound complications.
The occurrence of wound problems after the removal of a soft tissue sarcoma not only causes discomfort and a decline in quality of life for the patient and their environment, but also leads to a greater consumption of time and resources, and additionally results in a higher cost for society. Therefore, it would be beneficial to implement the use of closed incision negative pressure therapy in the future to prevent these wound problems from developing. However, some patients undergoing surgery for the removal of a soft tissue sarcoma who never develop any type of complication. Therefore, it is useful to identify the group of patients with the biggest risk of developing complications and apply the negative pressure wound therapy specifically to these patients. This focus could lead to better patient outcomes and a more efficient use of healthcare resources, ultimately benefiting both patients and society.
| Promotor | Gwen Sys |
| Opleiding | Geneeskunde |
| Domein | Chirurgie |
| Kernwoorden | closed incision negative pressure therapy soft tissue sarcoma resection wound healing sarcoma resection |