Management of extremely hard ‐to‐heal extremity wounds with severe life‐threatening complications

We present a series of four patients with soft tissue sarcoma of the thigh undergoing tumour removal and reconstruction of the defect after neoadjuvant radiotherapy. The post‐operative outcome depended on the total dose of radiation used as well as the closing technique of the resulting wound. Major wound complications occurred when the irradiated skin was closed directly over the resection cavity or when local skin flaps were used. In one case, severe radiation‐induced life‐threatening multiple bleeding events occurred, which led to multiple flap failures. Even if the skin cover is not a problem, we propose a combined interdisciplinary approach involving immediate plastic surgical transfer of healthy, well‐vascularised tissue into a defect resulting from oncological resection of sarcoma of the lower extremity following neoadjuvant radiotherapy in order to avoid secondary wound breakdown and severe bleeding complications.

Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Aijia Cai, Anja M Boos, Andreas Arkudas, Raymund E Horch Tags: ORIGINAL ARTICLE Source Type: research