Zusammenfassung
Einleitung: Lokoregionäre Rezidive nach Mammakarzinom sind mit einer schlechten Prognose verbunden.
Zur operativen Sanierung sind oft aufwendige Eigengewebsdeckungen notwendig. Patientinnen und Methode: Drei Patientinnen wurden im Rahmen der Rezidivresektion mit dem vakuumassistierten
Wundverschlusssystem versorgt. In allen Fällen war eine primäre lokale Deckung nicht
möglich. Ergebnisse: Die beschriebenen Fälle zeigten in der postoperativen Phase eine gute Wundheilung.
Die Bestrahlung und die Chemotherapie bei liegendem VAC-System waren problemlos möglich.
Schlussfolgerung: Durch den Einsatz von vakuumassistiertem Wundverschluss kann bei ausgedehnten lokoregionären
Rezidiven eine Eigengewebsdeckung umgangen werden.
Abstract
Loco-regional recurrence of mastocarcinoma is associated with a bad prognosis. Extensive
and complicated surgical treatment using autologous tissue is often necessary to repair
and cover defects. Patients and Methods: Three female patients were treated with the VAC system after undergoing resection
for recurrence. In all cases local primary coverage was not possible. Results: In the described cases the wounds healed well during the postoperative phase. No
problems with the inlying VAC systems occurred during radiation treatment or during
chemotherapy. Conclusion: Vacuum-assisted wound closure is a potential option which allows the surgeon to avoid
autologous tissue treatment in cases with extensive loco-regional recurrence.
Schlüsselwörter
Mammakarzinom - Rezidiv - Vakuum‐assistierter Wundverschluss - VAC
Key words
breast - cancer - recurrence - vacuum assisted closure - VAC
Literatur
1 Hayes D. An overview of treatment for locally advanced, recurrent, and metastatic
breast cancer. www.uptodate.com . 1.1.2008 Ref Type: Electronic Citation
2
Dian D, Schwenn K, Friese K. et al .
Morbidity after mastectomy and immediate autologous reconstruction.
Geburth Frauenheilk.
2006;
66
469-473
3 Funke I.
Behandlung des lokalen und regionären Tumorrezidivs. Sauer H, Hrsg. Tumorzentrum München, Manual Mammakarzinome. München; W. Zuckschwerdt
Verlag 2005: 217-224
4
Moues C M, Vos M C, van den Bemd G J. et al .
Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective
randomized trial.
Wound Repair Regen.
2004;
12
11-17
5
Moues C M, van den Bemd G J, Heule F. et al .
Comparing conventional gauze therapy to vacuum-assisted closure wound therapy: a prospective
randomised trial.
J Plast Reconstr Aesthet Surg.
2007;
60
672-681
6
Argenta L C, Morykwas M J.
Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.
Ann Plast Surg.
1997;
38
563-576
7
Morykwas M J, Argenta L C, Shelton-Brown E I. et al .
Vacuum-assisted closure: a new method for wound control and treatment: animal studies
and basic foundation.
Ann Plast Surg.
1997;
38
553-562
8
Alvarez A A, Maxwell G L, Rodriguez G C.
Vacuum-assisted closure for cutaneous gastrointestinal fistula management.
Gynecol Oncol.
2001;
80
413-416
9
Flack S, Apelqvist J, Keith M. et al .
An economic evaluation of VAC therapy compared with wound dressings in the treatment
of diabetic foot ulcers.
J Wound Care.
2008;
17
71-78
10
Immer F F, Durrer M, Muhlemann K S. et al .
Deep sternal wound infection after cardiac surgery: modality of treatment and outcome.
Ann Thorac Surg.
2005;
80
957-961
11
Polykandriotis E, Kneser U, Kopp J. et al .
Modified gloving technique for vacuum therapy in the hand.
Zentralbl Chir.
2006;
131 (Suppl. 1)
S36-S39
12
Vuerstaek J D, Vainas T, Wuite J. et al .
State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing
vacuum-assisted closure (V.A.C.) with modern wound dressings.
J Vasc Surg.
2006;
44
1029-1037
13
Wondberg D, Larusson H J, Metzger U. et al .
Treatment of the open abdomen with the commercially available vacuum-assisted closure
system in patients with abdominal sepsis: low primary closure rate.
World J Surg.
2008;
32
2724-2729
Darius Dian
Universitätsfrauenklinik München Campus Innenstadt
Maistraße 11
80337 München
eMail: darius.dian@med.uni-muenchen.de