Staged reconstruction for resection wounds in sarcoma patients treated with brachytherapy

Lior Heller, Matthew Ballo, Janice N. Cormier, Scott D. Oates, Charles E. Butler

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Adjuvant brachytherapy reduces local recurrences following wide local excision of large, high-grade sarcomas, but its use with immediate flap reconstruction is associated with a high wound complication rate following previous radiotherapy. To avoid flap irradiation and reduce wound-healing morbidity, a treatment strategy using negative-pressure wound therapy (NPWT) for temporary wound coverage during brachytherapy followed by delayed flap reconstruction was used in 3 previously irradiated sarcoma patients. NPWT was continued after brachytherapy catheter removal to stimulate vascularization, granulation, and wound contraction. Flap reconstructions were performed after the adequacy of the resection margins was pathologically confirmed and the wound bed appeared grossly vascularized. Prior to reconstruction, 2 patients required additional excision of positive or close permanent-section surgical margins. There were no major wound-healing complications during 9-18 months' follow-up. Staged closure using this approach may have advantages over immediate flap reconstruction in some sarcoma patients. Potential advantages include avoiding flap irradiation, reducing wound size and magnitude of the reconstructive procedure, and ensuring tumor-free surgical margins before definitive reconstruction.

Original languageEnglish (US)
Pages (from-to)58-63
Number of pages6
JournalAnnals of Plastic Surgery
Volume60
Issue number1
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

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Brachytherapy
Sarcoma
Negative-Pressure Wound Therapy
Wounds and Injuries
Wound Healing
Radiotherapy
Catheters
Morbidity
Recurrence
Margins of Excision

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Staged reconstruction for resection wounds in sarcoma patients treated with brachytherapy. / Heller, Lior; Ballo, Matthew; Cormier, Janice N.; Oates, Scott D.; Butler, Charles E.

In: Annals of Plastic Surgery, Vol. 60, No. 1, 01.01.2008, p. 58-63.

Research output: Contribution to journalArticle

Heller, Lior ; Ballo, Matthew ; Cormier, Janice N. ; Oates, Scott D. ; Butler, Charles E. / Staged reconstruction for resection wounds in sarcoma patients treated with brachytherapy. In: Annals of Plastic Surgery. 2008 ; Vol. 60, No. 1. pp. 58-63.
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