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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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Autores principales: Sanniec, Kyle J., Velazco, Cristine S., Bryant, Lyndsey A., Zhang, Nan, III, William J. Casey, Mahabir, Raman C., Rebecca, Alanna M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961807/
https://www.ncbi.nlm.nih.gov/pubmed/27478403
http://dx.doi.org/10.1155/2016/7972318
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author Sanniec, Kyle J.
Velazco, Cristine S.
Bryant, Lyndsey A.
Zhang, Nan
III, William J. Casey
Mahabir, Raman C.
Rebecca, Alanna M.
author_facet Sanniec, Kyle J.
Velazco, Cristine S.
Bryant, Lyndsey A.
Zhang, Nan
III, William J. Casey
Mahabir, Raman C.
Rebecca, Alanna M.
author_sort Sanniec, Kyle J.
collection PubMed
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.
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spelling pubmed-49618072016-07-31 Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes Sanniec, Kyle J. Velazco, Cristine S. Bryant, Lyndsey A. Zhang, Nan III, William J. Casey Mahabir, Raman C. Rebecca, Alanna M. Sarcoma Research Article 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. Hindawi Publishing Corporation 2016 2016-07-13 /pmc/articles/PMC4961807/ /pubmed/27478403 http://dx.doi.org/10.1155/2016/7972318 Text en Copyright © 2016 Kyle J. Sanniec et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Sanniec, Kyle J.
Velazco, Cristine S.
Bryant, Lyndsey A.
Zhang, Nan
III, William J. Casey
Mahabir, Raman C.
Rebecca, Alanna M.
Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title 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_short Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes
title_sort immediate versus delayed sarcoma reconstruction: impact on outcomes
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961807/
https://www.ncbi.nlm.nih.gov/pubmed/27478403
http://dx.doi.org/10.1155/2016/7972318
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