Delayed wound healing and wound complications

Warning
  • Bevacizumab has a half-life of about 20 days (range 11-50). 
  • VEGF-i therapy can delay wound healing after surgery and impair wound healing during surgery. 
  • No increased bleeding or complications if venous access device implanted shortly before starting VEGF-i.
  • Usually recommend waiting at least 7 days before starting VEGF-i after line/port placement and not placing line until >7 days after last dose of VEGF-i (depends a bit on half life of VEGF-i)

Managing risk of wound complications with VEGF-i therapy

  • VEGF-i therapy should not be started for at least 4 weeks following surgery or until the wound is fully healed  
  • Wait 6-8 weeks after the last dose of VEGF-i before any elective major surgery is planned.  
  • If an emergency surgical procedure is necessary during VEGF-i therapy, the risk of wound complications must be recognized and appropriate measures taken to minimize these.
  • Discontinue VEGF-i if any wound complication (fistula, dehiscence) develops or if intra-abdominal abscess. 

Editorial Information

Last reviewed: 05/01/2024

Next review date: 05/01/2027

Author(s): Edinburgh Cancer Centre.

Version: 1.1

Approved By: Authorised by CTAC. Refer to Q-Pulse for approval details.

Reviewer name(s): Stewart J.