title: Wound complications following pre-operative radiotherapy for soft tissue sarcoma.
abstract: OBJECTIVE
  We analysed wound complications in 43 patients with soft tissue sarcoma who were treated with combined pre-operative radiotherapy and surgery.
  
  
  METHODS
  All patients received the same protocol of pre-operative radiotherapy at our institution.
  
  
  RESULTS
  Thirty-six (84%) patients developed acute skin toxicity following radiotherapy. After wide local excision, 15 patients required primary soft tissue reconstruction with vascularized muscle transfer and four patients underwent free skin flap to enable wound closure as part of their primary surgery. Nineteen patients (44%) developed post-operative wound complications including 10 (23%) patients who required an additional surgical procedure. Four (27%) patients developed flap necrosis in a group of 15 who underwent primary vascularized soft tissue transfer. All required a second vascularized muscular flap. One elderly patient, who had grade 3 acute radiation skin toxicity, had an arterial graft and total hip arthroplasty for a femoral artery aneurysm and an avascular necrosis of the hip, respectively. In our series, age (> or = 40 years) was the only impact factor influencing wound complication after surgery following radiotherapy (P=0.06).
  
  
  CONCLUSIONS
  Site of tumour, radiation field size, surgical resection volume, grade of acute radiation toxicity, co-morbidity, and smoking were not demonstrated to have predictive value in wound complication following pre-operative radiotherapy. Although previous papers suggested that vascularized soft tissue transfer could be useful reducing wound morbidity, our results could not confirm this.
authors.affiliation: Bone and Soft Tissue Sarcoma Unit, St. Vincent's Hospital and Peter MacCallum Cancer Institute, Level 3 Daly Wing, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Kunisada
authors.forename: S Y
authors.initials: SY
authors.lastname: Ngan
authors.forename: G
authors.initials: G
authors.lastname: Powell
authors.forename: P F M
authors.initials: PF
authors.lastname: Choong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011832:Radiation Injuries / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012509:Sarcoma / Q000532:radiotherapy* / Q000601:surgery; D012867:Skin / Q000528:radiation effects; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D014945:Wound Healing / Q000528:radiation effects*