Vascularized tissue transfer for closure of irradiated wounds after soft tissue sarcoma resection.
During the years 1985 to 1989, 82 patients were included in the soft tissue sarcoma protocol. Preoperative irradiation (50-54 Gy) was performed in all patients before tumor extirpation. Microwave hyperthermia was performed in conjunction with radiation in patients who had gross tumor remaining after initial biopsy. Primary closure with vascularized tissue (flaps) in lieu of conventional wound closure by skin approximation led to less complications (19% versus 51%), fewer secondary procedures for wound closure (10% versus 35%), shorter average hospitalization (15 versus 48 days) and greater limb salvage rate (97% versus 91%). The authors conclude that vascularized tissue (flaps) for primary wound closure in irradiated tissue leads to improved wound healing, and should be considered the procedure of choice for heavily irradiated soft tissue sarcoma defects.
Barwick
W J
WJ
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, North Carolina.
Goldberg
J A
JA
Scully
S P
SP
Harrelson
J M
JM
D003131:Combined Modality Therapy; D005121:Extremities; D006801:Humans; D006979:Hyperthermia, Induced; D011300:Preoperative Care; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery* / Q000628:therapy; D016038:Skin Transplantation; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy / Q000601:surgery* / Q000628:therapy; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control*; D014945:Wound Healing / Q000528:radiation effects*