Simple Test Predicts Sarcoma Wound Healing Complications

A new study reveals that transcutaneous oximetry (TcO2) may be able to predict which patients with soft tissue sarcomas will experience complications while healing from surgery.

Researchers at Loyola University Medical Center (Maywood, IL, USA) and the University of Iowa (Iowa City, USA) followed 10 patients who underwent surgery for soft tissue sarcomas in the lower limbs after receiving radiation treatment. All patients underwent TcO2, a noninvasive test that measures the oxygen level of tissue beneath the skin using adhesive sensors. Measurements were obtained at five time points and at five locations around the operative field, as well as on the contra-lateral limb.

The researchers found that the average mean TcO2 measurement was 51.8 mmHg pre-radiation, 57.1 mmHg mid-treatment, 53.3 mmHg post-treatment, 49.5 mmHg preoperatively, and 54.0 mmHg postoperatively. Patients without complications had a mean preoperative TcO2 of 53.8 mmHg, compared to 42.9 mmHg in patients with complications. Four of the seven patients who had levels lower than 25 mmHg just before surgery experienced wound complications, while all three patients with oxygen levels higher than 25 mmHg healed without difficulty. The study was presented at the annual meeting of the Musculoskeletal Tumor Society (MSTS), held during October 2014 in Orlando (FL, USA).

“Anoxic tissue from preoperative radiation may contribute to surgical wound complications, and TcO2 measurements made preoperatively can predict wounds at risk,” concluded study authors Lukas Nystrom, MD, and Benjamin Miller, MD. “Extra precautions could then be taken to prevent complications, such as increasing the time between radiation and surgery and performing additional tissue transfers and vacuum-assisted closure.”

Soft tissue sarcomas are cancers that originate in tissues such as muscles, fat, blood vessels, nerves, and tendons. External beam radiation therapy, in combination with surgical resection, is used to improve local control. Advantages of preoperative radiation include smaller overall field size and dose which is believed to result in improved function of the spared limb. Furthermore, it may potentiate limb salvage by allowing safe marginal resection along vital neurovascular structures. But while patients often do better and require less radiation when it is administered before surgery, this also increases the risk of wound-healing complications.

Related Links:
Loyola University Medical Center
University of Iowa