Peat B G, Bell R S, Davis A, O'Sullivan B, Mahoney J, Manktelow R T, Bowen V, Catton C, Fornasier V L, Langer F
University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada.
Plast Reconstr Surg. 1994 Apr;93(5):980-7. doi: 10.1097/00006534-199404001-00012.
One-hundred and eighty patients undergoing limb-salvage surgery for soft-tissue sarcoma from 1986 to 1991 were assessed retrospectively for risk factors associated with major wound-healing complications. Twenty-three of 137 patients (16 percent) treated with primary direct wound closure sustained complications. In univariate analysis, the cross-sectional area of tumor resection, the use of preoperative irradiation, the width of the skin excision, a history of smoking, and a history of diabetes and/or vascular disease were associated with wound failure. Multivariate analysis revealed that preoperative irradiation (p = 0.04) and resection diameter (p = 0.017) accounted for the risk of complications. Eighteen additional patients were treated empirically with distant vascularized tissue transfer following preoperative irradiation because of concerns regarding potential wound complications. The lower complication rate in this group suggested that vascularized tissue transfer may be beneficial in lowering wound complication rates.
对1986年至1991年期间接受肢体挽救手术治疗软组织肉瘤的180例患者进行回顾性评估，以确定与严重伤口愈合并发症相关的危险因素。137例接受一期直接伤口缝合治疗的患者中有23例（16%）出现并发症。单因素分析显示，肿瘤切除的横截面积、术前放疗的使用、皮肤切除的宽度、吸烟史以及糖尿病和/或血管疾病史与伤口愈合失败有关。多因素分析显示，术前放疗（p = 0.04）和切除直径（p = 0.017）是并发症发生的危险因素。由于担心潜在的伤口并发症，另外18例患者在术前放疗后经验性地接受了远处带血管组织转移治疗。该组较低的并发症发生率表明，带血管组织转移可能有助于降低伤口并发症发生率。
