Patients will be recruited at the time of the pre-admission visit. During the screening visit the patient will undergo a physical examination and his medical history will be collected. Oncological history and tumor characteristics will be considered and CT-scan imaging will be analysed. ECOG performance status will be reported. If inclusion criteria are respected, the patient will be randomized. The application of the PICO14 study device or standard dressing (dry gauze and plaster) will then be carried out on the day of surgery. For subjects randomized to the treatment arm (Arm A), dressing change with the application of the new PICO14 will occur at day 4+1, day 8±1, and day 14±2. For subjects randomized to the control arm (Arm B), the standard dressing with gauze and plaster is applied. Regardless of the randomization arm the wound assessment via ASEPSIS score will occur at day 4+1, 8±1 and 14±2. During FUP, the dressing can be changed autonomously by the patient if necessary. The information will be recorded on the occasion of the next visit or an extraordinary visit. On day 21, sutures will be removed.
On day 30±2, the total ASEPSIS score will be calculated, in order to evaluate the wound healing.
From day 14±2, regardless of the randomization arm all patients will be treated with standard dressing.
Follow-up visits can be scheduled up to 90 days after surgery.
Male or female ≥ 18 years of age
diagnosis of primary high-grade (grade III) soft tissue sarcoma of the limbs (confirmed histopathologically)
performed neoadjuvant radiotherapy (short or long-term)
candidates for wide radical excision surgery
diagnosis of benign neoplasm
diagnosis of retroperitoneal or trunk sarcomas;
candidates to hindquarter or forequarter amputation surgery;
incomplete wide excision;
Parallel
PICO 14
DevicePICO 14 application after neoadjuvant radiotherapy followed by surgery
Primary objective and endpoint
Assess, in patients with wide excision surgery of radio treated limb sarcoma, if the preventive application of single-use negative pressure wound dressing (PICO 14) may reduce the incidence of wound complications at 30° day compared to the standard procedure currently in use. Primary objective will be evaluated according to the ASEPSIS score. For each patient the Daily ASEPSIS score will be calculated at days 4, 8 and 14 after surgery.
Secondary objective and endpoint
Evaluate and compare the incidence of long-term wound complications. All complications occurred between day 31 and day 90 after surgery will be collected and reported at the time of appearance, by ASEPSIS score
Third objective and endpoint
Verify the impact of the type of wound dressing in the length of hospital-stay. 2. The length of hospital stay will be calculated as the difference between the date of hospital discharge and the date of surgery
Fourth objective and endpoint
Evaluate the outpatient care time. 3. Outpatient care time will be calculated as the difference between the date of the last outpatient medication and the date of discharge.
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