Acute Oncology Guidelines
- 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.
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)