Major wound complication risk factors following soft tissue sarcoma resection

Eur J Surg Oncol. 2014 Dec;40(12):1671-6. doi: 10.1016/j.ejso.2014.10.045. Epub 2014 Oct 18.


Background and objectives: Wound-healing complications represent an important source of morbidity in patients treated surgically for soft tissue sarcomas (STS). The purpose of this study was to determine which factors are predictive of major wound complication rates following STS resection, including tumor site, size, grade, and depth, as well as radiotherapy and chemotherapy.

Methods: We reviewed 256 cases of STS treated surgically between 2000 and 2011. The primary outcome was occurrence of major wound complications post STS resection.

Results: Major wound complications were more likely to occur post STS resection with larger tumor diameters (p = 0.001), high grade tumors (p = 0.04), location in the proximal lower extremity (p = 0.01), and use of preoperative radiotherapy (p = 0.01). Tumors located in the adductor compartment were at highest risk of complications. We did not demonstrate a significant difference in complications rates based on method of closure. Diabetes, smoking, obesity, tumor diameter, tumor location in the proximal lower extremity, and preoperative radiotherapy were independent predictors on multivariate analysis.

Conclusions: There are multiple predictors for major wound complications post STS resection. A more aggressive resection irradiated soft tissues, combined with primary reconstruction, should be considered in cases with multiple risk factors.

Keywords: Humans; Postoperative complications/surgery*; Retrospective studies; Sarcoma/radiotherapy; Sarcoma/surgery; Wound healing.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Comorbidity
  • Databases, Factual
  • Diabetes Complications / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Neoplasm Grading
  • Obesity / complications
  • Predictive Value of Tests
  • Radiotherapy, Adjuvant / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Sarcoma / pathology*
  • Sarcoma / radiotherapy
  • Sarcoma / surgery*
  • Smoking / adverse effects
  • Surgical Wound Dehiscence / etiology*
  • Surgical Wound Infection / etiology*
  • Thigh
  • Wound Healing