Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction
Summary Background Upper limb preservation after soft tissue sarcoma resection often requires flap reconstruction. The aim of this study was to compare pre- and post-operative upper limb function following shoulder, elbow or wrist/hand sarcoma resection and soft tissue reconstruction with a pedicled...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2013-05, Vol.66 (5), p.601-607 |
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| creator | Payne, Caroline E Hofer, Stefan O.P Zhong, Toni Griffin, Anthony C Ferguson, Peter C Wunder, Jay S |
| description | Summary Background Upper limb preservation after soft tissue sarcoma resection often requires flap reconstruction. The aim of this study was to compare pre- and post-operative upper limb function following shoulder, elbow or wrist/hand sarcoma resection and soft tissue reconstruction with a pedicled or free flap. Patients Between 1989 and 2008, 113 patients underwent resection of an upper limb soft tissue sarcoma and required flap reconstruction. Perioperative morbidity, mortality and flap loss were studied. Functional outcome was assessed pre and postoperatively using the Toronto Extremity Salvage Score (TESS), a measure of disability, and the Musculoskeletal Tumour Society Rating Scale (MSTS), a measure of impairment. Statistical analyses were performed to evaluate the relationship between flap type and functional outcome scores. Results Patients underwent soft tissue sarcoma excision in the shoulder ( n = 64), elbow ( n = 27) or wrist/hand ( n = 22) region with soft tissue reconstruction using either a pedicled ( n = 76) or free flap ( n = 37). Comparison of the post-operative MSTS ( n = 88) and TESS ( n = 84) revealed no significant differences between the free and pedicled flap groups. A significant pre- to post-operative difference was identified in MSTS 87 scores for patients in both the pedicled ( p |
| doi_str_mv | 10.1016/j.bjps.2013.01.034 |
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The aim of this study was to compare pre- and post-operative upper limb function following shoulder, elbow or wrist/hand sarcoma resection and soft tissue reconstruction with a pedicled or free flap. Patients Between 1989 and 2008, 113 patients underwent resection of an upper limb soft tissue sarcoma and required flap reconstruction. Perioperative morbidity, mortality and flap loss were studied. Functional outcome was assessed pre and postoperatively using the Toronto Extremity Salvage Score (TESS), a measure of disability, and the Musculoskeletal Tumour Society Rating Scale (MSTS), a measure of impairment. Statistical analyses were performed to evaluate the relationship between flap type and functional outcome scores. Results Patients underwent soft tissue sarcoma excision in the shoulder ( n = 64), elbow ( n = 27) or wrist/hand ( n = 22) region with soft tissue reconstruction using either a pedicled ( n = 76) or free flap ( n = 37). Comparison of the post-operative MSTS ( n = 88) and TESS ( n = 84) revealed no significant differences between the free and pedicled flap groups. A significant pre- to post-operative difference was identified in MSTS 87 scores for patients in both the pedicled ( p < 0.02) and free flap groups ( p < 0.04). Comparison of the pre- and post-operative MSTS 93 scores also revealed a significant difference ( p < 0.01) but this was limited to the free flap group. The most notable post-operative score reductions in these patients were due to major joint, nerve, tendon or muscle group resection. Conclusion Reconstruction of the soft tissue defect following sarcoma resection in the upper limb maintains a similar satisfactory level of upper limb activity with either pedicled or free flap reconstructions. Based on TESS scores, patients rated themselves as having better function compared to impairment measures such as MSTS.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2013.01.034</identifier><identifier>PMID: 23434111</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Female ; Flap reconstruction ; Follow-Up Studies ; Free Tissue Flaps ; Functional outcome ; Humans ; Limb Salvage ; Male ; Middle Aged ; Plastic Surgery ; Prospective Studies ; Reconstructive Surgical Procedures - methods ; Recovery of Function ; Sarcoma - pathology ; Sarcoma - surgery ; Sarcoma resection ; Soft Tissue Neoplasms - pathology ; Soft Tissue Neoplasms - surgery ; Treatment Outcome ; Upper Extremity - physiopathology ; Upper Extremity - surgery ; Upper limb</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2013-05, Vol.66 (5), p.601-607</ispartof><rights>British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-eced1c5518c385508c4677e5ab0a89f3b08be0ab3caa02d1cff5c212c3a203273</citedby><cites>FETCH-LOGICAL-c444t-eced1c5518c385508c4677e5ab0a89f3b08be0ab3caa02d1cff5c212c3a203273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681513000600$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23434111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Payne, Caroline E</creatorcontrib><creatorcontrib>Hofer, Stefan O.P</creatorcontrib><creatorcontrib>Zhong, Toni</creatorcontrib><creatorcontrib>Griffin, Anthony C</creatorcontrib><creatorcontrib>Ferguson, Peter C</creatorcontrib><creatorcontrib>Wunder, Jay S</creatorcontrib><title>Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Summary Background Upper limb preservation after soft tissue sarcoma resection often requires flap reconstruction. The aim of this study was to compare pre- and post-operative upper limb function following shoulder, elbow or wrist/hand sarcoma resection and soft tissue reconstruction with a pedicled or free flap. Patients Between 1989 and 2008, 113 patients underwent resection of an upper limb soft tissue sarcoma and required flap reconstruction. Perioperative morbidity, mortality and flap loss were studied. Functional outcome was assessed pre and postoperatively using the Toronto Extremity Salvage Score (TESS), a measure of disability, and the Musculoskeletal Tumour Society Rating Scale (MSTS), a measure of impairment. Statistical analyses were performed to evaluate the relationship between flap type and functional outcome scores. Results Patients underwent soft tissue sarcoma excision in the shoulder ( n = 64), elbow ( n = 27) or wrist/hand ( n = 22) region with soft tissue reconstruction using either a pedicled ( n = 76) or free flap ( n = 37). Comparison of the post-operative MSTS ( n = 88) and TESS ( n = 84) revealed no significant differences between the free and pedicled flap groups. A significant pre- to post-operative difference was identified in MSTS 87 scores for patients in both the pedicled ( p < 0.02) and free flap groups ( p < 0.04). Comparison of the pre- and post-operative MSTS 93 scores also revealed a significant difference ( p < 0.01) but this was limited to the free flap group. The most notable post-operative score reductions in these patients were due to major joint, nerve, tendon or muscle group resection. Conclusion Reconstruction of the soft tissue defect following sarcoma resection in the upper limb maintains a similar satisfactory level of upper limb activity with either pedicled or free flap reconstructions. Based on TESS scores, patients rated themselves as having better function compared to impairment measures such as MSTS.</description><subject>Female</subject><subject>Flap reconstruction</subject><subject>Follow-Up Studies</subject><subject>Free Tissue Flaps</subject><subject>Functional outcome</subject><subject>Humans</subject><subject>Limb Salvage</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Plastic Surgery</subject><subject>Prospective Studies</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Recovery of Function</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - surgery</subject><subject>Sarcoma resection</subject><subject>Soft Tissue Neoplasms - pathology</subject><subject>Soft Tissue Neoplasms - surgery</subject><subject>Treatment Outcome</subject><subject>Upper Extremity - physiopathology</subject><subject>Upper Extremity - surgery</subject><subject>Upper limb</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1TAURC1ERUvhB1ggL9kk3Gs7L66EkFBFAakSi7ZbLMfvBhycONhJq_49Tl9hwYKVLfvMSDPD2CuEGgF3b4e6G-ZcC0BZA9Yg1RN2grrVFTTy7Gm5t0pXO43NMXue8wCgJKrmGTsWUkmFiCfs28U6ucXHyQYe18XFkXgfQ4h3fvrO13mmxIMfO55jv_DF57wSzzYV0PJEmR7E_M4vP3gf7FzeXJzyktaHjxfsqLch08vH85TdXHy8Pv9cXX799OX8w2XllFJLRY726JoGtZO6aUA7tWtbamwHVp_1sgPdEdhOOmtBFLTvGydQOGkFSNHKU_bm4Dun-GulvJjRZ0ch2Inimg1KIYVGJTdUHFCXYs6JejMnP9p0bxDM1qsZzNar2Xo1gKb0WkSvH_3XbqT9X8mfIgvw7gBQSXnrKZnsPE0lly-NLGYf_f_93_8jd8FP3tnwk-4pD3FNZaGSw2RhwFxty27DogSAHYD8DZVpoDY</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Payne, Caroline E</creator><creator>Hofer, Stefan O.P</creator><creator>Zhong, Toni</creator><creator>Griffin, Anthony C</creator><creator>Ferguson, Peter C</creator><creator>Wunder, Jay S</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction</title><author>Payne, Caroline E ; Hofer, Stefan O.P ; Zhong, Toni ; Griffin, Anthony C ; Ferguson, Peter C ; Wunder, Jay S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-eced1c5518c385508c4677e5ab0a89f3b08be0ab3caa02d1cff5c212c3a203273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Female</topic><topic>Flap reconstruction</topic><topic>Follow-Up Studies</topic><topic>Free Tissue Flaps</topic><topic>Functional outcome</topic><topic>Humans</topic><topic>Limb Salvage</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Plastic Surgery</topic><topic>Prospective Studies</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Recovery of Function</topic><topic>Sarcoma - pathology</topic><topic>Sarcoma - surgery</topic><topic>Sarcoma resection</topic><topic>Soft Tissue Neoplasms - pathology</topic><topic>Soft Tissue Neoplasms - surgery</topic><topic>Treatment Outcome</topic><topic>Upper Extremity - physiopathology</topic><topic>Upper Extremity - surgery</topic><topic>Upper limb</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Payne, Caroline E</creatorcontrib><creatorcontrib>Hofer, Stefan O.P</creatorcontrib><creatorcontrib>Zhong, Toni</creatorcontrib><creatorcontrib>Griffin, Anthony C</creatorcontrib><creatorcontrib>Ferguson, Peter C</creatorcontrib><creatorcontrib>Wunder, Jay S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Payne, Caroline E</au><au>Hofer, Stefan O.P</au><au>Zhong, Toni</au><au>Griffin, Anthony C</au><au>Ferguson, Peter C</au><au>Wunder, Jay S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>66</volume><issue>5</issue><spage>601</spage><epage>607</epage><pages>601-607</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Summary Background Upper limb preservation after soft tissue sarcoma resection often requires flap reconstruction. The aim of this study was to compare pre- and post-operative upper limb function following shoulder, elbow or wrist/hand sarcoma resection and soft tissue reconstruction with a pedicled or free flap. Patients Between 1989 and 2008, 113 patients underwent resection of an upper limb soft tissue sarcoma and required flap reconstruction. Perioperative morbidity, mortality and flap loss were studied. Functional outcome was assessed pre and postoperatively using the Toronto Extremity Salvage Score (TESS), a measure of disability, and the Musculoskeletal Tumour Society Rating Scale (MSTS), a measure of impairment. Statistical analyses were performed to evaluate the relationship between flap type and functional outcome scores. Results Patients underwent soft tissue sarcoma excision in the shoulder ( n = 64), elbow ( n = 27) or wrist/hand ( n = 22) region with soft tissue reconstruction using either a pedicled ( n = 76) or free flap ( n = 37). Comparison of the post-operative MSTS ( n = 88) and TESS ( n = 84) revealed no significant differences between the free and pedicled flap groups. A significant pre- to post-operative difference was identified in MSTS 87 scores for patients in both the pedicled ( p < 0.02) and free flap groups ( p < 0.04). Comparison of the pre- and post-operative MSTS 93 scores also revealed a significant difference ( p < 0.01) but this was limited to the free flap group. The most notable post-operative score reductions in these patients were due to major joint, nerve, tendon or muscle group resection. Conclusion Reconstruction of the soft tissue defect following sarcoma resection in the upper limb maintains a similar satisfactory level of upper limb activity with either pedicled or free flap reconstructions. Based on TESS scores, patients rated themselves as having better function compared to impairment measures such as MSTS.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>23434111</pmid><doi>10.1016/j.bjps.2013.01.034</doi><tpages>7</tpages></addata></record> |
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| subjects | Female Flap reconstruction Follow-Up Studies Free Tissue Flaps Functional outcome Humans Limb Salvage Male Middle Aged Plastic Surgery Prospective Studies Reconstructive Surgical Procedures - methods Recovery of Function Sarcoma - pathology Sarcoma - surgery Sarcoma resection Soft Tissue Neoplasms - pathology Soft Tissue Neoplasms - surgery Treatment Outcome Upper Extremity - physiopathology Upper Extremity - surgery Upper limb |
| title | Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction |
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