title: Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes.
abstract: Background. Sarcoma is a rare malignancy, and more recent management algorithms emphasize a multidisciplinary approach and limb salvage, which has resulted in an increase in overall survival and limb preservation. However, limb salvage has resulted in a higher rate of wound complications. Objective. To compare the complications between immediate and delayed (>three weeks) reconstruction in the multidisciplinary limb salvage sarcoma patient population. Methods. A ten-year retrospective review of patients who underwent sarcoma resection was performed. The outcome of interest was wound complication in the postoperative period based on timing of reconstruction. We defined infection as any infection requiring intravenous antibiotics, partial flap failure as any flap requiring a debridement or revision, hematoma/seroma as any hematoma/seroma requiring drainage, and wound dehiscence as a wound that was not completely intact by three weeks postoperatively. Results. 70 (17 delayed, 53 immediate) patients who underwent sarcoma resection and reconstruction met the inclusion criteria. Delayed reconstruction significantly increased the incidence of postoperative wound infection and wound dehiscence. There was no difference in partial or total flap loss, hematoma, or seroma between the two groups. Discussion and Conclusion. Immediate reconstruction results in decreased wound complications may reduce the morbidity associated with multidisciplinary treatment in the limb salvage sarcoma patient.
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern, 1801 Inwood Road, Dallas, TX 75390, USA.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Sanniec
authors.affiliation: Division of General Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USA.
authors.forename: Cristine S
authors.identifier: 0000-0002-5366-1270
authors.initials: CS
authors.lastname: Velazco
authors.affiliation: Division of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USA.
authors.forename: Lyndsey A
authors.identifier: 0000-0001-6878-2342
authors.initials: LA
authors.lastname: Bryant
authors.affiliation: Division of Health Sciences Research, Mayo Clinic in Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Casey
authors.affiliation: Division of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USA.
authors.forename: Raman C
authors.identifier: 0000-0002-9145-4563
authors.initials: RC
authors.lastname: Mahabir
authors.affiliation: Division of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USA.
authors.forename: Alanna M
authors.identifier: 0000-0002-4920-2442
authors.initials: AM
authors.lastname: Rebecca