Flap Reconstruction Decreases Complication Rates following Resection of Adductor Compartment Soft Tissue Sarcoma

OrthoMedia ◽  
2022 ◽  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Complication Rates ◽  
Flap Reconstruction

Patient, tumour and treatment factors affect complication rates in soft tissue sarcoma flap reconstruction in a synergistic manner

2017 ◽  
Vol 43 (6) ◽  
pp. 1126-1133 ◽  
Author(s):  
J. Slump ◽  
P.C. Ferguson ◽  
J.S. Wunder ◽  
A.M. Griffin ◽  
H.J. Hoekstra ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Complication Rates ◽  
Flap Reconstruction

Flap reconstruction does not increase complication rates following surgical resection of extremity soft tissue sarcoma

2018 ◽  
Vol 44 (2) ◽  
pp. 251-259 ◽  
Author(s):  
Jelena Slump ◽  
Stefan O.P. Hofer ◽  
Peter C. Ferguson ◽  
Jay S. Wunder ◽  
Anthony M. Griffin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Surgical Resection ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Extremity Soft Tissue Sarcoma

Flap Reconstruction of Sarcoma Defects in the Setting of Neoadjuvant and Adjuvant Radiation

2018 ◽  
Vol 35 (04) ◽  
pp. 287-293 ◽  
Author(s):  
Rohini Kadle ◽  
Catherine Motosko ◽  
George Zakhem ◽  
John Stranix ◽  
Timothy Rapp ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Radiation Treatment ◽  
Soft Tissue Sarcomas ◽  
Adjuvant Radiation ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Fasciocutaneous Flaps ◽  
Musculoskeletal Tumor Society

Background Limb-sparing treatment of extremity soft tissue sarcomas requires wide resections and radiation therapy. The resulting complex composite defects necessitate reconstructions using either muscle or fasciocutaneous flaps, often in irradiated wound beds. Methods A retrospective chart review was performed of all limb-sparing soft tissue sarcoma resections requiring immediate flap reconstruction from 2012 through 2016. Results Forty-four patients with 51 flaps were identified: 25 fasciocutaneous and 26 muscle-based flaps. Mean defect size, radiation treatment, and follow-up length were similar between groups. More often, muscle-based flaps were performed in younger patients and in the lower extremity. Seventeen flaps were exposed to neoadjuvant radiation, 12 to adjuvant radiation, 5 to both, and 17 to no radiation therapy. Regardless of radiation treatment, complication rates were comparable, with 28% in fasciocutaneous and 31% in muscle-based groups (p < 0.775). Muscle-based flaps performed within 6 weeks of undergoing radiotherapy were less likely to result in complications than those performed after greater than 6 weeks (p < 0.048). At time of follow-up, Musculoskeletal Tumor Society scores for fasciocutaneous and muscle-based reconstructions, with or without radiation, showed no significant differences between groups (mean [SD]: 91% [8%] vs. 89% [13%]). Conclusion The similar complication rates and functional outcomes in this study support the safety and efficacy of both fasciocutaneous flaps and muscle-based flaps in reconstructing limb-sparing sarcoma resection defects, with or without radiotherapy.

scholarly journals Patient’s quality of life after surgery and radiotherapy for extremity soft tissue sarcoma - a retrospective single-center study over ten years

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Rebekka Götzl ◽  
Sebastian Sterzinger ◽  
Sabine Semrau ◽  
Nikolaos Vassos ◽  
Werner Hohenberger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Major Complication ◽  
Neoadjuvant Radiochemotherapy ◽  
Complication Rates ◽  
Extremity Soft Tissue Sarcoma ◽  
Disease Free

Abstract Background and objectives The purpose of this study is to analyze major complication rates and different aspects of health-related quality of life (HRQoL) in extremity soft tissue sarcoma (STS) patients treated with or without radio (chemo) therapy and surgery. Methods We performed a retrospective analysis of all patients who underwent Extremity STS excision from 2004 to 2014 (182 patients included). Patients’ data were collected from patients’ records. HRQoL was assessed by using EORTC QLQ-C30. Results A total of 182 patients underwent sarcoma resection. After neoadjuvant radiochemotherapy (RCT), the major-complication rate amounted to 28% (vs. 7%, no radiotherapy, p <  0.001). Major-complication rates after adjuvant radiotherapy (RT) occurred in 8% (vs. 7%, no radiotherapy, p = 0.265). Comparison QoL scores between treating with neoadjuvant RCT or without RT revealed significant worse scores with neoadjuvant RCT. Further stratification of disease control of these patients showed significant reduced scores in the group of disease-free patients with neoadjuvant RCT compared to irradiated disease-free patients. Discussion To date, there have only been a few investigations of QoL in STS. Retrospective study on quality of life have limitations, like a lack of baseline evaluation of QoL. Patient candidated to radiation therapy could have had worse QoL baseline due to more advanced disease. Disease status of the patients who answered the questionnaires could have been an influence of QoL and we could show reduced scores in the group of disease-free patients with neoadjuvant RCT, but not for the patients with recurrence or metastasis, so it is very hard to discriminate whether radiation therapy could really have an impact or not. Conclusion This study might assist in further improving the understanding of QoL in STS patients and may animate for prospective studies examining the oncological therapies impact on HRQoL.

Flap choice does not affect complication rates or functional outcomes following extremity soft tissue sarcoma reconstruction

2018 ◽  
Vol 71 (7) ◽  
pp. 989-996 ◽  
Author(s):  
Jelena Slump ◽  
Stefan O.P. Hofer ◽  
Peter C. Ferguson ◽  
Jay S. Wunder ◽  
Anthony M. Griffin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Functional Outcomes ◽  
Complication Rates ◽  
Extremity Soft Tissue Sarcoma

scholarly journals Predictors of the surgical outcome of propeller perforator flap reconstruction, focusing on the effective safe distance between the perforator and the wound edge

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peng Wang ◽  
Fang Lin ◽  
Yunhong Ma ◽  
Jianbing Wang ◽  
Ming Zhou ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Free Tissue Transfer ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Safe Distance ◽  
Defect Location ◽  
Propeller Flap ◽  
Tissue Transfer ◽  
Shortest Distance

Abstract Background Soft tissue defects in the distal third of the leg and malleolus are difficult to cover and often require free tissue transfer, even for small-sized defects. Propeller flaps were designed as an alternative to free tissue transfer, but are reportedly associated with high complication rates. The aim of our study was to assess our institutional experience with the propeller flap technique and to predict its outcome in lower-limb reconstruction. Methods All patients who had undergone propeller flap reconstruction of a distal leg defect between 2013 and 2018 were included. Demographic, clinical, and follow-up data were analyzed. Results Complications occurred in 17 of 82 propeller flaps (20.7%), comprising 11 cases of partial necrosis and six of total necrosis. There were no significant differences in age, sex, body mass index smoking, diabetes mellitus, and soft tissue defect sites between the groups of patients with versus without flap necrosis (p > 0.05). In univariate analysis, there were also no significant differences between these two groups in the length and width of the fascial pedicle, and the ratio of the flap length to the flap width (p > 0.05). Interestingly, there were significant differences between the two groups in the distance between the flap perforator, the shortest distance from the perforator to the defect location, and the rotation angle of the flap (p < 0.05). In multivariable logistic regression analysis with odds ratios (ORs) and 95% confidence intervals (95% CIs), the shortest distance from the perforator to the defect location was a significant risk factor for flap complications (p = 0.000; OR = 0.806). Receiver operating characteristic curve analysis showed that when the shortest distance from the flap to the wound was less than 3.5 cm, the necrosis rate of the flap was markedly increased (AUC = 76.1); this suggests that the effective safe flap–wound distance was 3.5 cm. Conclusions Propeller flaps are a reliable option for reconstruction in carefully selected patients with traumatic defects of the lower limb and malleolus. We found that the effective safe distance was 3.5 cm from the flap to the wound.

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