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Test may predict wound-healing issues after sarcoma removal

A simple test called transcutaneous oximetry might be able to predict which patients are most likely to experience wound-healing complications after surgery to remove a soft tissue sarcoma, according to a new small study.

As many as 35% of patients who undergo surgery to remove soft tissue sarcomas experience wound-healing complications because of radiation they receive before surgery. Being able to predict which patients are at higher risk could possibly help surgeons take extra precautions, according to a news release.

Study co-author Lukas Nystrom, MD, an orthopedic oncologist at Loyola University Medical Center in Maywood, Ill., presented his findings Oct. 16 during the 2014 annual meeting of the Musculoskeletal Tumor Society in Houston, Texas. Nystrom received the society’s New Investigator Award for the study, according to the release.

Soft tissue sarcomas are cancers that originate in the soft tissues, such as muscles, fat, blood vessels, nerves and tendons. External beam radiation typically is part of the treatment regimen. Patients often do better, and require less radiation, when radiation is administered before surgery; however, administering radiation before surgery also increases the risk of wound-healing complications.

Transcutaneous oximetry, a noninvasive test, measures the oxygen level of tissue beneath the skin by placing adhesive sensors that contain electrodes on the skin. The test causes no side effects or discomfort.

For the study, researchers followed 10 patients who underwent surgery for soft tissue sarcomas after receiving radiation treatment. They found patients with lower transcutaneous oxygen levels before surgery were more likely to experience wound complications. Four of the seven patients who had levels lower than 25 mmHg just before surgery experienced wound complications, the study showed, while all three patients with oxygen levels higher than 25 mmHg healed without difficulty.

Nystrom said the study population is small, and further work is necessary to confirm the findings. If confirmed by further study, transcutaneous oximetry could become a tool to predict which patients are most at risk for wound complications. Extra precautions then could be taken to prevent complications, such as increasing the time interval between radiation and surgery and performing additional tissue transfers and vacuum-assisted closure, Nystrom said in the release.

The study was performed at the University of Iowa Hospitals & Clinics in Iowa City, where Nystrom did his residency. The co-author is Benjamin Miller, MD, of the University of Iowa.

“Transcutaneous oximetry represents a potential tool for decisions regarding surgical timing or potentially other medical and surgical efforts to diminish wound complications,” Nystrom and Miller wrote in the study. “However, given this small sample size, more data is needed to further assess the relationship.”

Nystrom and Miller are applying for funding to conduct a prospective, multicenter study to confirm these findings, according to the release.

Nystrom also is an assistant professor in the Department of Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine.

The abstract for Paper 27 can be viewed online at http://msts.org/education_meetings/2014%20MSTS%20Online%20Final%20Program.pdf.

By | 2014-10-31T00:00:00-04:00 October 31st, 2014|Categories: National|0 Comments

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