Inguinal lymphadenectomy in penile cancer is associated with a high rate of wound complications. The aim of this trial was to prospectively analyze the effect of an epidermal vacuum wound dressing on lymphorrhea, complications and reintervention in patients with inguinal lymphadenectomy for penile cancer.
Prospective, multicenter, randomized, investigator-initiated study in two German university hospitals (2013-2017). Thirty-one patients with penile cancer and indication for bilateral inguinal lymph node dissection were included and randomized to conventional wound care on one side (CONV) versus epidermal vacuum wound dressing (VAC) on the other side.
A smaller cumulative drainage fluid volume until day 14 (CDF) compared to contralateral side was observed in 15 patients (CONV) vs. 16 patients (VAC), with a median CDF 230 ml (CONV) vs. 415 ml (VAC) and a median maximum daily fluid volume (MDFV) of 80 ml (CONV) vs. 110 ml (VAC). Median time of indwelling drainage: 7 days (CONV) vs. 8 days (VAC). All grade surgery-related complications were seen in 74% patients (CONV) vs. 74% patients (VAC); grade 3 complications in 3 patients (CONV) vs. 6 patients (VAC). Prolonged hospital stay occurred in 32% patients (CONV) vs. 48% patients (VAC); median hospital stay was 11.5 days. Reintervention due to complications occurred in 45% patients (CONV) vs. 42% patients (VAC).
In this prospective, randomized trial we could not observe a significant difference between epidermal vacuum treatment and conventional wound care.
World journal of urology. 2020 May 05 [Epub ahead of print]
Sebastian C Schmid, Anna K Seitz, Bernhard Haller, Hans-Martin Fritsche, Toni Huber, Maximilian Burger, Jürgen E Gschwend, Tobias Maurer
Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Ismaningerstr. 22, 81375, Munich, Germany. ., Department of Urology, Universitätsklinikum Würzburg, Würzburg, Germany., Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich, Munich, Germany., Department of Urology, Universitätsklinikum Regensburg, Regensburg, Germany., Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Ismaningerstr. 22, 81375, Munich, Germany.