title: Outcomes analysis of the role of plastic surgery in extremity sarcoma treatment.
abstract: Over the past 5 years we have developed a multidisciplinary service for the treatment of extremity sarcoma. This service includes orthopedic oncology, neurosurgery, medical and radiation oncology, and plastic surgery. Prior to 2007, the role of plastic surgery in this multidisciplinary team was limited. After 2007, plastic surgery at our institution played an increasingly integral role in multidisciplinary care. Based on the development of the plastic surgery service at our institution, we were able to evaluate the role of plastic surgery in the outcomes following extremity reconstruction after sarcoma resection. We hypothesize that plastic surgery involvement would reduce the amputation rate without altering recurrence rates. We found a decrease in lower-extremity amputation of approximately 20% without any significant change in recurrence rates. The incidence of infectious complications requiring IV antibiotics decreased by about 20%. The incidence of skin graft loss decreased by 75%. We do report a significant increase in partial flap necrosis. Overall, plastic surgery is an essential component of the multidisciplinary team in the care of extremity sarcoma.
authors.affiliation: Department of Plastic Surgery, Ohio State University, Columbus, Ohio 43215, USA. Nikhil.agrawal@osumc.edu
authors.forename: Nikhil
authors.initials: N
authors.lastname: Agrawal
authors.forename: Dinah
authors.initials: D
authors.lastname: Wan
authors.forename: Zachary
authors.initials: Z
authors.lastname: Bryan
authors.forename: James
authors.initials: J
authors.lastname: Boehmler
authors.forename: Mike
authors.initials: M
authors.lastname: Miller
authors.forename: Pankaj
authors.initials: P
authors.lastname: Tiwari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D023821:Limb Salvage; D035002:Lower Extremity / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000517:prevention & control*; D009820:Ohio / Q000453:epidemiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013518:Surgery, Plastic / Q000379:methods; D013524:Surgical Flaps; D015996:Survival Rate