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Deep Infection After Ilioinguinal Node Dissection: Vacuum-Assisted Closure Therapy?

Department of Surgery, Rijnland Hospital, Leiderdorp, the Netherlands, p.steenvoorde{at}lumc.nl

Eveline Slotema, MD

Department of Surgery, Rijnland Hospital, Leiderdorp, the Netherlands

Santosh Adhin, MD

Department of Surgery, Rijnland Hospital, Leiderdorp, the Netherlands

Jacques Oskam, MD, PhD

Department of Surgery, Rijnland Hospital, Leiderdorp, the Netherlands

Wound infection rates after ilioinguinal node dissection are high; 9% to 16% have been reported. The authors report a patient who underwent an ilioinguinal node dissection for a regional metastasized melanoma. Unfortunately, a deep wound infection occurred with extensive skin necrosis and production of abundant wound fluid (750 cc daily). Despite 6-daily dressings, the wound deteriorated, necessitating further operative debridement. In theatre, the authors failed to identify the lymphatic fistula and therefore were unable to close it. In accordance with literature on treatment of groin infections after vascular prosthesis, vacuum-assisted closure (VAC) therapy was started. After 11 days of VAC therapy, the lymphatic leakage completely stopped. Concurrent successful management of the wound with split skin graft therapy led to a complete closure of the wound. The treatment was not painful, changes of the sponge could be done in the ward, and there were no complications.

Key Words: ilioinguinal node dissection • vacuum-assisted closure • infection • chronic wound management

The International Journal of Lower Extremity Wounds, Vol. 3, No. 4, 223-226 (2004)
DOI: 10.1177/1534734604271141


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