Complications of Radiation Therapy to the Hand After Soft Tissue Sarcoma Surgery

Rohde, Rachel S.; Puhaindran, Mark E.; Morris, Carol D.; Alektiar, Kaled M.; Healey, John H.; Athanasian, Edward A.

doi:10.1016/j.jhsa.2010.08.030

Cited by 25 publications

(18 citation statements)

References 25 publications

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“…Other groups reported on complication rates in mixed patient cohorts, including cases with and without vascularised reconstruction, but did not separately describe morbidity for the different subsets of patients. Here, complications were observed in 6–35% of the patients . However, these studies suggested that flap reconstruction might help to reduce complication rates because the highest number of complications was found with the least number of flaps performed (9%) .…”

Section: Complications Of Radiotherapy With Free Flaps Compared To Prmentioning

confidence: 88%

“…23,25,28,49,50,54,55 However, these studies suggested that flap reconstruction might help to reduce complication rates because the highest number of complications was found with the least number of flaps performed (9%). 25 With the exception of two studies, 54,55 it was found that the higher the percentage of flaps used, the lower the incidence of complications as shown in Table 3. 23,25,28,49,50 Radiation therapy is not the only factor influencing wound healing in STS patients.…”

Section: Complications Of Radiotherapy With Free Flaps Compared To mentioning

confidence: 99%

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Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Abouarab

Salem

Degheidy

et al. 2017

International Wound Journal

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Soft tissue sarcomas occur most commonly in the lower and upper extremities. The standard treatment is limb salvage surgery combined with radiotherapy. Postoperative radiotherapy is associated with wound complications. This systematic review aims to summarise the available evidence and review the literature of the last 10 years regarding postoperative wound complications in patients who had limb salvage surgical excision followed by direct closure vs flap coverage together with postoperative radiotherapy and to define the optimal timeframe for adjuvant radiotherapy after soft tissue sarcomas resection and flap reconstruction. A literature search was performed using PubMed. The following keywords were searched: limb salvage, limb‐sparing, flaps, radiation therapy, radiation, irradiation, adjuvant radiotherapy, postoperative radiotherapy, radiation effects, wound healing, surgical wound infection, surgical wound dehiscence, wound healing, soft tissue sarcoma and neoplasms. In total, 1045 papers were retrieved. Thirty‐seven articles were finally selected after screening of abstracts and applying dates and language filters and inclusion and exclusion criteria. Plastic surgery provides a vast number of reconstructive flap procedures that are directly linked to decreasing wound complications, especially with the expectant postoperative radiotherapy. This adjuvant radiotherapy is better administered in the first 3–6 weeks after reconstruction to allow timely wound healing and avoid local recurrence.

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Section: Complications Of Radiotherapy With Free Flaps Compared To Prmentioning

confidence: 88%

Section: Complications Of Radiotherapy With Free Flaps Compared To mentioning

confidence: 99%

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Abouarab

Salem

Degheidy

et al. 2017

International Wound Journal

View full text Add to dashboard Cite

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“…A single-ray or multiple-ray resection was not considered a failure of limb salvage. 21,22,25 Superficial tumors were defined as those above the fascia.…”

Section: Methodsmentioning

confidence: 99%

What Factors Influence the Outcome of Surgically Treated Soft Tissue Sarcomas of the Hand and Wrist?

Houdek

Walczak

Wilke

et al. 2016

Hand (New York, N,Y.)

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“…In humans, some bone sarcomas, most commonly Ewing sarcoma, adjuvant radiotherapy is a treatment option, being reported adverse effects of radiation therapy on up to 74% of patients [76][77][78], namely wound healing problems, infection, muscle and joint contracture, ankylosis, osteitis, non-union, pathological fractures, tendon adhesion, and radiation induced sarcoma [76][77][78][79]. In a rabbit tibia model, it was demonstrated that radiation exposure decreases the quantity and quality of regenerate and angiogenesis during a DO [80].…”

Section: Distraction Osteogenesis After Oncologic Surgerymentioning

confidence: 99%

Distraction Osteogenesis: Biological Principles and Its Application in Companion Animals

Domingos¹,

Armés²,

Dias³

et al. 2021

Clinical Implementation of Bone Regeneration and Maintenance

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Distraction osteogenesis is a surgical technique widely used in orthopedic surgery for treatment of various pathological skeletal conditions, namely correction of limb-length discrepancies, angular deformity and treatment of distal and severely comminuted fractures, or bone defects through bone transport. The basic principle consists on the gradual distraction of two bone segments, previously submitted to a corticotomy and promptly fixated generally using of circular external skeletal fixation. New bone tissue is generated in the bone gap between the two segments. This review aims to describe the biological fundaments and principles of this technique, the surgical steps performed to attempt distraction osteogenesis, and its possible complications with main focus on its application in companion animals.Bone Grafts 2 latency period will be applied, and (iv) the distraction rate (DR) must be appropriate for the level and type of bone in which osteogenesis is being performed [5].After the separation of both segments, three temporal phases of DO can be defined: latency period, distraction period, and consolidation period [3]. Osteotomy and corticotomyThe DO procedure begins with the transverse section at a diaphyseal or metaphyseal level of the long bone to be elongated. Ilizarov described three methods to create fractures, including osteotomy, corticotomy, and osteoclasis. The osteogenic potential of the osteotomy or corticotomy depends on three main factors: the localization in bone, the type of technique used, and the latency period subsequently applied [6, 7].Regarding the localization, some researchers in the past referred that the bone lengthening should be performed in the middle of the diaphysis of the long bone, and when necessary elongation was obtained, a bone graft from the ilium crest could be applied on the distraction focus to promote its consolidation. Later, Ilizarov recognized the metaphysis as the ideal site for the osteotomy, due to its massive trabecular bone area, rich in collateral vascularization, and higher potential for fracture recovery. Other researchers compared the regenerated bone quality at the diaphysis and metaphysis after DO, while using different latency periods. In the metaphysis, latency periods of 0 and 7 days allowed a greater osteogenesis and a faster remodeling and consolidation, when compared to the diaphysis elongation. A latency period of 14-21 days was associated with a premature consolidation in both regions. Bone mineralization of the newly formed tissue was faster at the metaphysis than at the diaphysis. Curiously, when there was no latency period, the distraction was successful and the consolidation faster. The latency of 7 days did not reveal the risk of premature consolidation; however, the consolidation and bone formation were slower than where there was no latency period. Post mortem torsion and bending test revealed that the bone tissue elongated on the metaphysis was tougher and more resistant. Histologically, the osteogenesis is observed to be based on intra-mem...

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Complications of Radiation Therapy to the Hand After Soft Tissue Sarcoma Surgery

Cited by 25 publications

References 25 publications

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

What Factors Influence the Outcome of Surgically Treated Soft Tissue Sarcomas of the Hand and Wrist?

Distraction Osteogenesis: Biological Principles and Its Application in Companion Animals

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