Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes

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....

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Main Authors: Kyle J. Sanniec, Cristine S. Velazco, Lyndsey A. Bryant, Nan Zhang, William J. Casey III, Raman C. Mahabir, Alanna M. Rebecca
Format: Article
Language:English
Published: Hindawi Limited 2016-01-01
Series:Sarcoma
Online Access:http://dx.doi.org/10.1155/2016/7972318
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spelling doaj-1c50a15e854446cba53fd915b88f16bf2020-11-24T22:50:15ZengHindawi LimitedSarcoma1357-714X1369-16432016-01-01201610.1155/2016/79723187972318Immediate versus Delayed Sarcoma Reconstruction: Impact on OutcomesKyle J. Sanniec0Cristine S. Velazco1Lyndsey A. Bryant2Nan Zhang3William J. Casey III4Raman C. Mahabir5Alanna M. Rebecca6Department of Plastic Surgery, University of Texas Southwestern, 1801 Inwood Road, Dallas, TX 75390, USADivision of General Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADivision of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADivision of Health Sciences Research, Mayo Clinic in Arizona, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USADivision of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADivision of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADivision of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USABackground. 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.http://dx.doi.org/10.1155/2016/7972318
collection DOAJ
language English
format Article
sources DOAJ
author Kyle J. Sanniec
Cristine S. Velazco
Lyndsey A. Bryant
Nan Zhang
William J. Casey III
Raman C. Mahabir
Alanna M. Rebecca
spellingShingle Kyle J. Sanniec
Cristine S. Velazco
Lyndsey A. Bryant
Nan Zhang
William J. Casey III
Raman C. Mahabir
Alanna M. Rebecca
Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
Sarcoma
author_facet Kyle J. Sanniec
Cristine S. Velazco
Lyndsey A. Bryant
Nan Zhang
William J. Casey III
Raman C. Mahabir
Alanna M. Rebecca
author_sort Kyle J. Sanniec
title Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title_short Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title_full Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title_fullStr Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title_full_unstemmed Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title_sort immediate versus delayed sarcoma reconstruction: impact on outcomes
publisher Hindawi Limited
series Sarcoma
issn 1357-714X
1369-1643
publishDate 2016-01-01
description 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.
url http://dx.doi.org/10.1155/2016/7972318
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