TY - JOUR
T1 - Large-defect Resurfacing
T2 - A comparison of skin graft results following sarcoma resection and traumatic injury repair
AU - Hanada, Masuo
AU - Kadota, Hideki
AU - Yoshida, Sei
AU - Takeuchi, Naohide
AU - Okada, Takamitsu
AU - Matsumoto, Yoshihiro
AU - Nakashima, Yasuharu
N1 - Publisher Copyright:
© 2019 HMP Communications. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Introduction. Soft tissue sarcomas are rare neoplasms, and most plastic surgeons do not commonly resurface large tissue defects after a wide resection of these tumors. Objective. The purpose of this study is to elucidate the clinical results of large skin grafts after wide sarcoma resection by comparison with grafts for traumatic skin defects. Materials and Methods. A retrospective review was performed of patients who received skin grafts > 50 cm2 after traumatic injury or wide sarcoma resection from 2014 to 2016. Patient medical records were reviewed; graft take rate, graft loss, and days to complete epithelialization were compared between the 2 groups. Results. In the sarcoma group (n = 8), 5 grafts were partially lost; the sarcoma group mean graft take rate of 67.5% ± 30.0% was significantly lower than that of the trauma group (n = 7) at 99.6% ± 1.1%. The mean time to complete epithelialization from the skin graft placement in the sarcoma group was 113.3 ± 66.0 days, which was significantly longer than that of the trauma group (40.3 ± 38.0 days). Wounds located around the shoulder joint in 2 sarcoma group patients did not heal even after 300 days of conservative treatment; 1 required a secondary flap. Conclusions. The results of skin grafting for resurfacing large defects after sarcoma resection are inferior to those for traumatic injury repair. Skin grafts may fail because the blood supply for the wound bed is impaired during resection. Furthermore, due to the wound bed movement, epithelialization over muscles of the shoulder joint is difficult to achieve, and skin grafts in this region will likely fail.
AB - Introduction. Soft tissue sarcomas are rare neoplasms, and most plastic surgeons do not commonly resurface large tissue defects after a wide resection of these tumors. Objective. The purpose of this study is to elucidate the clinical results of large skin grafts after wide sarcoma resection by comparison with grafts for traumatic skin defects. Materials and Methods. A retrospective review was performed of patients who received skin grafts > 50 cm2 after traumatic injury or wide sarcoma resection from 2014 to 2016. Patient medical records were reviewed; graft take rate, graft loss, and days to complete epithelialization were compared between the 2 groups. Results. In the sarcoma group (n = 8), 5 grafts were partially lost; the sarcoma group mean graft take rate of 67.5% ± 30.0% was significantly lower than that of the trauma group (n = 7) at 99.6% ± 1.1%. The mean time to complete epithelialization from the skin graft placement in the sarcoma group was 113.3 ± 66.0 days, which was significantly longer than that of the trauma group (40.3 ± 38.0 days). Wounds located around the shoulder joint in 2 sarcoma group patients did not heal even after 300 days of conservative treatment; 1 required a secondary flap. Conclusions. The results of skin grafting for resurfacing large defects after sarcoma resection are inferior to those for traumatic injury repair. Skin grafts may fail because the blood supply for the wound bed is impaired during resection. Furthermore, due to the wound bed movement, epithelialization over muscles of the shoulder joint is difficult to achieve, and skin grafts in this region will likely fail.
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M3 - Article
C2 - 31306097
AN - SCOPUS:85069905439
SN - 1044-7946
VL - 31
SP - 184
EP - 192
JO - Wounds
JF - Wounds
IS - 7
ER -