Wound complications in preoperatively irradiated soft-tissue sarcomas of the extremities.
OBJECTIVE
To determine whether the involvement of plastic surgery and the use of vascularized tissue flaps reduces the frequency of major wound complications after radiation therapy for soft-tissue sarcomas (STS) of the extremities.


METHODS
This retrospective study evaluated patients with STS of the extremities who underwent radiation therapy before surgery. Major complications were defined as secondary operations with anesthesia, seroma/hematoma aspirations, readmission for wound complications, or persistent deep packing.


RESULTS
Between 1996 and 2010, 73 patients with extremity STS were preoperatively irradiated. Major wound complications occurred in 32% and secondary operations in 16% of patients. Plastic surgery closed 63% of the wounds, and vascularized tissue flaps were used in 22% of closures. When plastic surgery performed closure the frequency of secondary operations trended lower (11% vs 26%; P=.093), but the frequency of major wound complications was not different (28% vs 38%; P=.43). The use of a vascularized tissue flap seemed to have no effect on the frequency of complications. The occurrence of a major wound complication did not affect disease recurrence or survival. For all patients, 3-year local control was 94%, and overall survival was 72%.


CONCLUSIONS
The rates of wound complications and secondary operations in this study were very similar to previously published results. We were not able to demonstrate a significant relationship between the involvement of plastic surgery and the rate of wound complications, although there was a trend toward reduced secondary operations when plastic surgery was involved in the initial operation. Wound complications were manageable and did not compromise outcomes.
Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina 27514, USA.
Lewis A
LA
Rosenberg
Robert J
RJ
Esther
Kamil
K
Erfanian
Rebecca
R
Green
Hong Jin
HJ
Kim
Raeshell
R
Sweeting
Joel E
JE
Tepper
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D011300:Preoperative Care / Q000009:adverse effects / Q000379:methods; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D049291:Seroma / Q000209:etiology / Q000601:surgery; D013396:Suction; D013524:Surgical Flaps / Q000098:blood supply; D047368:Tumor Burden; D055815:Young Adult