Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Orthopaedic Surgery, Karolinska University Hospital, Stockholm, Sweden.
Eur J Surg Oncol. 2024 Jun;50(6):108348. doi: 10.1016/j.ejso.2024.108348. Epub 2024 Apr 16.
Immediate vascularized reconstruction after sarcoma resection may reduce wound complications common in primary closure, but previous research is conflicting. The present study analysed wound complication rates and compared wound-related outcomes among immediate vascularized reconstruction with primary closure.
Patient- and tumour characteristics were collected from patients who received primary surgery with curative intent between 2010 and 2020 at the Stockholm Sarcoma Centre. Clinical outcomes were sought in free text in medical records. The primary outcome measures were early (<30 days) wound complications. Secondary outcome measures included late (30-day to 2-year) wound complications, time to wound healing, 30-day postoperative complications according to Clavien Dindo, and health care consumption.
A total of 482 patients were included, of whom 69 had immediate vascularized reconstruction. Comparison of early complications for reconstructive surgery with primary closure revealed a significantly higher complication rate for the first group (59.4 % vs 29.8 %, p < 0.01). The groups had comparable health care consumption the first and second postoperative years. In-depth analyses identified BMI >25, smoking and high-grade lesions as factors with adverse effects on wound healing.
Sarcoma patients experience high rates of wound complications and consume considerable health care resources. Reconstructed individuals were more susceptible to such complications than were subjects with primary closure.
在肉瘤切除术后立即进行血管化重建可能会减少原发性闭合术常见的伤口并发症，但之前的研究结果存在冲突。本研究分析了即刻血管化重建与原发性闭合术的伤口并发症发生率，并比较了与伤口相关的结果。
从 2010 年至 2020 年在斯德哥尔摩肉瘤中心接受根治性原发性手术的患者中收集患者和肿瘤特征。在病历的自由文本中寻求临床结果。主要结局指标为早期（<30 天）伤口并发症。次要结局指标包括晚期（30 天至 2 年）伤口并发症、伤口愈合时间、根据 Clavien Dindo 分类的 30 天术后并发症以及医疗保健消耗。
共纳入 482 例患者，其中 69 例患者行即刻血管化重建。重建手术与原发性闭合术早期并发症的比较显示，第一组的并发症发生率明显更高（59.4%比 29.8%，p<0.01）。两组在术后第一和第二年的医疗保健消耗相当。深入分析发现 BMI>25、吸烟和高级别病变是对伤口愈合有不利影响的因素。
肉瘤患者的伤口并发症发生率较高，消耗大量的医疗保健资源。与原发性闭合术相比，重建的患者更容易出现此类并发症。
