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

Abstract

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.

Efficacy of resveratrol in the wound healing process by reducing oxidative stress and promoting fibroblast cell proliferation and migration

“…1 Interruption of the process at different phases of these stages leads to complicated and impaired WHs. WH impairment and complications are common among diabetic-, 2,3 immunosuppressed-, 4,5 and radiotherapy-treated, 6,7 patients. The management and treatment of WH are challenging and expensive.…”

“…WH impairment and complications are common among diabetic‐, 2,3 immunosuppressed‐, 4,5 and radiotherapy‐treated, 6,7 patients. The management and treatment of WH are challenging and expensive.…”

Are Topical Skin Adhesives An Option For Wound Closure Following Musculoskeletal Oncology Surgery? A STROCSS-Compliant Observational Study

“…However, complications associated with post-operative wound healing, especially for musculoskeletal oncology patients, remain a challenge. Reports have been available for such complications in soft tissue-associated sarcoma for decades [23][24][25]. Several associated factors, such as dehiscence, infection, and stula, have been examined to understand their effects in complicated surgical wounds [26].…”

Outcomes of 2-octyl cyanoacrylate skin adhesives following musculoskeletal oncology surgery

“…Reports have been available for such complications in soft tissue-associated sarcomas for decades. [ 23 – 25 ] Several associated factors, such as dehiscence, infection, and fistula, have been examined to understand their effects on complicated surgical wounds. [ 26 ]…”