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Impact of subcutaneous negative pressure drains on surgical wound healing in ovarian cancer
  1. Young Shin Chung,
  2. Jung-Yun Lee,
  3. Eun Ji Nam,
  4. Sunghoon Kim,
  5. Sang Wun Kim and
  6. Young Tae Kim
  1. Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
  1. Correspondence to Professor Jung-Yun Lee, Department of Gynecology and Obstetrics, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea; yodrum682{at}gmail.com

Abstract

Introduction Subcutaneous negative pressure wound drains have been used to reduce wound complication rates in various surgical procedures. However, research on the benefits of subcutaneous drains on wound healing after ovarian cancer surgery is limited. The aim of this study was to assess the effects of subcutaneous negative pressure drains on wound healing after abdominal surgery for ovarian cancer.

Methods Patients who underwent surgery with a midline incision for ovarian cancer between February 2015 and May 2019 were retrospectively examined. Patients were divided into two groups according to the presence (group 1; n=99) or absence (group 2; n=213) of subcutaneous wound drains. The primary endpoint was the incidence of wound complications within 8 weeks after abdominal surgery. The secondary endpoints were time interval from surgery to adjuvant chemotherapy and survival.

Results Patients in group 1 were older (mean 58.5 vs 55.4 years; p=0.02), and had higher rates of previous abdominal surgery (66.7% vs 47.9%; p=0.002), bowel surgery (47.5% vs 34.3%; p=0.026), and had a high surgical complexity score (53.5% vs 33.8%; p<0.001) compared with patients in group 2. Median body mass index was not different between the two groups: group 1, 22.9 kg/m2 (range 16.0 to 33.3) and group 2, 22.8 kg/m2 (range 16.4 to 37.5) (p=0.858). A higher rate of clear wound healing (82.8% vs 71.8%; p=0.036) and a lower rate of seroma formation (6.1% vs 16.0%; p=0.015) were observed in group 1 compared with group 2. After multivariate analysis, subcutaneous wound drain placement was identified as an independent predictive factor for preventing wound complications (adjusted odds ratio 0.43; 95% confidence interval 0.21 to 0.87). Time interval from surgery to adjuvant treatment was significantly longer in patients with wound complications than in those with clear wound healing (mean 23.6 vs 19.2 days; p=0.003). Kaplan–Meier analysis, however, showed no significant differences in progression free or overall survival between the two groups (p=0.35 and p=0.96, respectively).

Conclusion The prophylactic use of subcutaneous negative pressure drains after abdominal surgery for ovarian cancer significantly reduced the incidence of wound complications in this study.

  • surgical wound Infection
  • ovarian neoplasms
  • surgical procedures, operative
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Footnotes

  • Contributors Conception and design of the study was done by YSC, J-YL, EJN, S-HK, SWK, and Y-TK. Data collection was done by S-HK and J-YL. Data analysis and interpretation was done by Y-TK and EJN. Statistical analysis was done by S-HK and Y-TK. Manuscript preparation was done by YSC and J-YL. Manuscript editing was done by YSC and S-HK. Patient recruitment was done by EJN and SWK. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was conducted with the approval of the institutional review board of Severance Hospital, Yonsei University College of Medicine (No 4-2019-0900).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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