Management of wound dehiscence with negative pressure in diabetic patients undergoing pulmonary resection for lung cancer.

BACKGROUND: Thoracotomy wound dehiscence, with or without infection, remains a challenging postoperative complication associated with delayed recovery and increased healthcare burden. Diabetes mellitus is a well-recognized risk factor for impaired wound healing. The aim of this study was to evaluate the role of a portable incisional negative-pressure wound therapy (iNPWT) device (PICO™) in the management of thoracotomy wound dehiscence in diabetic patients undergoing pulmonary resection for lung cancer. METHODS: This small retrospective comparative case series included 19 consecutive diabetic patients who developed thoracotomy wound dehiscence after pulmonary resection for lung cancer between February 2006 and June 2018. Following surgical wound revision, debridement, and complete wound re-closure, 9 patients received iNPWT with the PICO™ system (Group A), while 10 patients received conventional dressing (Group B). Continuous variables were expressed as median and interquartile range (IQR) and compared using the Mann-Whitney U test. Categorical variables were analyzed using Fisher's exact test. Statistical significance was set at p < 0.05. RESULTS: Baseline demographic and clinical characteristics were comparable between groups. Patients treated with the PICO™ system showed a significantly shorter time to complete wound healing compared with those receiving conventional dressing [10 days [8.25-12] vs. 13 days [12-14], p = 0.0238]. Complete wound healing was achieved in all patients. No significant differences in pain scores were observed between groups. CONCLUSIONS: In this small retrospective comparative case series, the use of the PICO™ system was associated with a shorter time to complete wound healing in diabetic patients with thoracotomy wound dehiscence. Given the retrospective design and limited sample size, these findings should be interpreted with caution. Larger prospective studies are warranted to confirm the potential role of incisional negative-pressure wound therapy in this clinical setting.