RISK OF VENOUS ACCESS DEVICE WOUND COMPLICATIONS IN PATIENTS UNDERGOING PACLITAXEL CHEMOTHERAPY FOR GYNECOLOGIC MALIGNANCIES

Objective, To determine if wound complications after placement of a ce ntral venous catheter access device are related to the type of postsur gical cytotoxic chemotherapy administered. Methods. All patients in a 10-year period undergoing placement of central venous access device fo llowed by postsurgical chemotherapy for gynecologic malignancies were included in this retrospective case-control study. Results. Sixty-eigh t patients underwent 78 placement procedures followed by chemotherapy, Six catheters (7.7%) in five patients developed wound complications. Variables evaluated included the type of gynecologic malignancy, previ ous use of chemotherapy, patient age and weight, preoperative white bl ood cell count, type of access device and insertion site, use of proph ylactic antibiotics, type of chemotherapy and interval to administrati on, development of wound complication, and catheter removal. Univariat e analysis shows an association between subsequent catheter site wound complication and paclitaxel use (P = 0.02) as well as wound complicat ion and combined paclitaxel and cisplatin use (P = 0.005), Multivariat e analysis with stepwise linear regression confirms that a paclitaxel containing regimen is associated with an increase in wound breakdown ( P = 0.04), Conclusion. The use of a paclitaxel containing chemotherape utic regimen administered after placement of an indwelling central ven ous access device in gynecologic oncology patients is associated with wound complications of the catheter site. (C) 1998 Academic Press.