This study of 195 patients with giant‐cell tumor reemphasizes the female predominance, the predilection for the region of the knee, and the extreme rarity of the tumor in patients with immature skeletons. One of the tumors occurred in a patient with Paget's disease of bone. There were 2 patients with 2 giant‐cell tumors each. Surgical treatment short of complete resection or amputation was followed by recurrence of benign giant‐cell tumor in 44.6% of cases. Adjunctive radiation or cautery did not decrease this rate. Primary en bloc resection or amputation was uniformly curative. Primary radiation therapy had very limited value. Sarcomas developed in 17 patients (8.7%) of the total; these lesions we have called malignant giant‐cell tumors. In 4 instances, zones of anaplastic sarcoma were found in otherwise typical giant‐cell tumors. The remaining 13 sarcomas were found in recurrent tumors, and in 11 of these, the primary treatment had included radiation. The evidence indicates that surgical removal is the best treatment and that radiation should be employed only for tumors that are unresectable because of their location.

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Objective. The correlation between obesity and deficient wound healing has long been established. This review examines the current literature on the mechanisms involved in obesity-related perioperative morbidity. Methods. A literature search was performed using Medline, PubMed, Cochrane Library, and Internet searches. Keywords used include obesity, wound healing, adipose healing, and bariatric and surgical complications. Results. Substantial evidence exists demonstrating that obesity is associated with a number of postoperative complications. Specifically in relation to wound healing, explanations include inherent anatomic features of adipose tissue, vascular insufficiencies, cellular and composition modifications, oxidative stress, alterations in immune mediators, and nutritional deficiencies. Most recently, advances made in the field of gene array have allowed researchers to determine a few plausible alterations and deficiencies in obese individuals that contribute to their increased risk of morbidity and mortality, especially wound complications. Conclusion. While the literature discusses how obesity may negatively affect health on various of medical fronts, there is yet to be a comprehensive study detailing all the mechanisms involved in obesity-related morbidities in their entirety. Improved knowledge and understanding of obesity-induced physiological, cellular, molecular, and chemical changes will facilitate better assessments of surgical risks and outcomes and create efficient treatment protocols for improved patient care of the obese patient population.