Reconstruction of sarcoma defects following pre-operative radiation: Free tissue transfer is safe and reliable

Townley, William A.; Mah, Eldon; OʼNeill, Anne C.; Wunder, Jay S.; Ferguson, Peter C.; Zhong, Toni; Hofer, Stefan O. P.

doi:10.1016/j.bjps.2013.06.029

Cited by 60 publications

(39 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The choice of combining either preoperative or postoperative radiotherapy with limb salvage surgery is still debatable. Postoperative radiotherapy can be applied as brachytherapy (BRT) or external beam radiotherapy (EBRT) . BRT usually starts on the fifth day postoperatively, while EBRT starts after 4 weeks.…”

Section: Introductionmentioning

confidence: 99%

“…In this context, either pedicled flaps or free microvascular flaps can be applied depending on the size and localisation of the defect. Microsurgical reconstruction of the oncological defects could be the sole option when local flaps cannot be used due to previous radiation or surgery at the donor site of the flap . Usui was the first who described the structured use of microsurgical free flaps for reconstruction after STS resection.…”

Section: Introductionmentioning

confidence: 99%

“…Postoperative radiotherapy can be applied as brachytherapy (BRT) or external beam radiotherapy (EBRT). 11 BRT usually starts on the fifth day postoperatively, while EBRT starts after 4 weeks. The latter results in less wound complications because of the longer postoperative interval allowing wound healing.…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

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.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

show abstract

“…In cases with particularly radiosensitive tumors, such as myxoid liposarcoma, preoperative radiation can lead to substantial tumor shrinkage prior to surgery and is associated with excellent outcomes [35–37]. Although preoperative radiation is associated with an increased risk of early wound complications, it does not impede successful microvascular anastomosis in cases needing free flaps for soft-tissue reconstruction, but avoids direct radiation to a free tissue transfer, rotational flap, or skin graft when needed for wound coverage [38]. …”

Section: Treatment Of Extremity Soft-tissue Sarcomasmentioning

confidence: 99%

“…Rotational flaps are highly predictable but recent advances have reduced the failure rate of free flaps to 1–4% [54]. Historically it was thought the vascular anastomosis for a free flap needed to be outside the zone of radiation; however, a recent study by Townley et al showed that preoperative radiation does not increase the rate of microvascular complications [38]. …”

Section: Soft-tissue Reconstructionmentioning

confidence: 99%

Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes

Ramu

Houdek

Isaac

et al. 2017

SICOT-J

View full text Add to dashboard Cite

Soft-tissue sarcomas (STS) are a rare group of malignant tumors which can affect any age group. For the majority of patients who present with a localized STS, treatment involves a multidisciplinary team decision-making approach ultimately relying on surgical resection with or without adjuvant radiation for successful limb salvage. The goals of treatment are to provide the patient with a functional extremity without local tumor relapse. The purpose of this article is to review the treatment of extremity STS, with a focus on staging, treatment options, and outcomes.

show abstract

Oncologic reconstruction of the hand and upper extremity: Maximizing functional outcomes

et al. 2016

View full text Add to dashboard Cite

Upper extremity malignancies have the potential to create significant functional impairment, and as such represent an opportunity for collaborative reconstruction to minimize potential morbidity. Given the increased complexity and array of potential reconstruction solutions, functional limb preservation is overwhelmingly and increasingly successful in appropriately selected patients. The purpose of this review is to familiarize the reader with the general functional considerations of the upper extremity, review major reconstructive options, and present a general algorithm for reconstruction and maintenance of function. J. Surg. Oncol. 2016;113:946-954. © 2016 Wiley Periodicals, Inc.

show abstract

Reconstruction of sarcoma defects following pre-operative radiation: Free tissue transfer is safe and reliable

Cited by 60 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

Management of soft-tissue sarcomas; treatment strategies, staging, and outcomes

Oncologic reconstruction of the hand and upper extremity: Maximizing functional outcomes

Contact Info

Product

Resources

About