Wound complication in surgery of soft tissue sarcoma. Analysis of 103 consecutive patients managed without adjuvant therapy

Abstract

In a consecutive series of 103 patients with soft tissue sarcoma, operated on from 1987 through 1990, clinical and perioperative factors were assessed for the development of wound complications. Local excision was performed in 98 cases and amputation in five. None had preoperative radiation therapy or chemotherapy. The overall incidence of wound complication was 40%. There were 16 infections, 13 necroses, and 12 hematomas. The complication rate was significantly lower in the upper extremity (17%) as compared with the trunk and lower extremity (45%). Superficially located and deep tumors had equal incidences of wound complications. Regarding deep tumors, wound complication was significantly related to large tumor size, old age, long operating time, and excessive blood loss. No such correlations could be found for superficial tumors. The median hospitalization time for patients with deep tumors who developed complications was 23 days, as compared with 11 days for those without. Complications in patients with superficial tumors did not lead to a lengthened hospital stay. A considerable complication rate was associated with limb-sparing surgery for soft tissue sarcomas. This incidence could probably be reduced by taking into account risk factors associated with wound complications, better preoperative planning, and close cooperation with plastic surgeons for adequate wound coverage.