Practicality of using the figure-of-eight bandage to prevent fatal wound dehiscence after spinal tumor surgery for upper thoracic metastasis

Abstract

Object: Serious postoperative wound problems can frequently develop after surgery with perioperative RT for upper thoracic metastatic lesions. The figure-of-eight bandage can restrict excessive shoulder motion, which could prevent wound dehiscence. The purpose of this study was to describe the efficacy of using the figure-of-eight bandage to prevent postoperative wound dehiscence.Methods: Between February 2005 and July 2015, we retrospectively evaluated the medical records of cancer patients who underwent surgery with or without RT for spinal metastasis involving the upper thoracic spine. From January 2009, all patients received figure-of-eight bandaging immediately postoperatively, which was then maintained for 2 months. The outcome measures were the incidence and successful management of wound dehiscence following application of the figure-of-eight bandage.Results: One hundred and fifteen patients (71 men and 44 women) were enrolled in the present study. A figure-of-eight bandage in conjunction with a thoracolumbosacral orthosis (TLSO) was applied to 78 patients, while only TLSO was applied to 37 patients. The overall rate of wound dehiscence was 4.34% and the mean duration before wound dehiscence was 27.0 days (range, 22–31 days) after surgery. In the TLSO-only group, wound dehiscence occurred in four patients (10.81%), meanwhile there was only one case (1.33%) of wound dehiscence in the group that had received the figure-of-eight bandage with TLSO. Three of four patients with wound dehiscence in the TLSO only group died from unresolved wound problems and another patient was treated with wound closure followed by the application of the figure-of-eight bandage. The only patient with wound dehiscence among the patients who received both the figure-of-eight bandage and TLSO was managed by primary wound closure without further complication.Conclusion: Current study suggests that the figure-of-eight bandage could prevent wound dehiscence and be used to treat wound problems easily.