Limb-sparing surgery for soft tissue sarcomas: wound related morbidity in patients undergoing wide local excision

When feasible, limb-sparing surgery has become an accepted form of treatment for sarcoma of the extremities. In a review of 100 consecutive cases of local excisions in patients with soft tissue sarcomas, which were performed at the National Cancer Institute, we identified factors associated with the development of wound-related morbidity. The incidence of these wound complications, which include infection, seromas, and skin loss, was 34.4%. Serious complications that necessitated rehospitalization or reoperation occurred in fewer than 10% of the patients. Preoperative factors associated with wound morbidity were patient age greater than 40 years (P2 less than 0.029) and tumor in the lower extremity (P2 less than 0.014). Treatment-related factors associated with morbidity were increased blood loss (p less than 0.01) and an increased volume (p less than 0.006) and duration (p less than 0.002) of wound drainage. The complications significantly delayed the start of adjuvant radiation therapy and lengthened the hospital stay. Measures to prevent these complications are discussed.