Journal article
What are the Results of Surgical Treatment of Postoperative Wound Complications in Soft Tissue Sarcoma? A Retrospective, Multi-Center Case Series
The Iowa orthopaedic journal, Vol.38, pp.131-136
2018
PMCID: PMC6047396
PMID: 30104935
Appears in Diamond Open Access
Abstract
Non-oncologic wound complications are common following resection of soft tissue sarcomas and factors predisposing to the development of complications have been extensively studied. To our knowledge, the methods and results of surgical treatment of these complications have not been reported. The purposes of this study were to 1) identify time to recognition, treatment employed, and eventual outcome of complications 2) investigate risk factors that may predispose patients to failure in management of complications following resection of soft tissue sarcomas.
This was a multi-institutional, retrospective case series of patients treated with a primary closure of a limb sparing resection of a soft tissue sarcoma of the pelvis or extremity who developed a non-oncologic wound complication requiring operative intervention. The primary outcomes were a healed wound at the end of treatment and the total number of procedures required to address the complication.
There were 61 patients from 11 institutions included in the analysis. The median time from surgery to the initial recognition of a complication was 22 days (range 0-173 days), with 51 patients (84%) presenting in the first six weeks postoperatively. The definitive procedures included primary closure (44), healing by secondary intention (9), muscle flap (6), and skin graft (2). No patient was treated with an amputation. Six patients (10%) had a wound requiring continued dressing changes. 12 patients (20%) required at least one (range 1-4) additional unplanned procedure. In a bivariate analysis, we found patients with an infection were at increased risk of requiring multiple unplanned procedures (p=0.024).
Limb sparing resection of a soft tissue sarcoma is known to be at high risk of postoperative wound complications. We found that complications uncommonly present greater than six weeks after initial treatment and surgical management predictably results in retention of the affected limb and a healed wound in those requiring operative treatment.
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Details
- Title: Subtitle
- What are the Results of Surgical Treatment of Postoperative Wound Complications in Soft Tissue Sarcoma? A Retrospective, Multi-Center Case Series
- Creators
- Sean Kennedy - The Musculoskeletal Oncology Research Initiative (sean-j-kennedy@uiowa.edu) (zachary-mayo@uiowa.edu) (yubo-gao@uiowa.edu)Zachary Mayo - The Musculoskeletal Oncology Research Initiative (sean-j-kennedy@uiowa.edu) (zachary-mayo@uiowa.edu) (yubo-gao@uiowa.edu)Yubo Gao - The Musculoskeletal Oncology Research Initiative (sean-j-kennedy@uiowa.edu) (zachary-mayo@uiowa.edu) (yubo-gao@uiowa.edu)Benjamin J Miller - The Musculoskeletal Oncology Research Initiative (sean-j-kennedy@uiowa.edu) (zachary-mayo@uiowa.edu) (yubo-gao@uiowa.edu)
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.38, pp.131-136
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 30104935
- PMCID
- PMC6047396
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Grant note
- T35 HL007485 / NHLBI NIH HHS P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 2018
- Academic Unit
- Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040581202771
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