Simple Test can Predict Who Are Likely to Face Wound Healing Complications

A simple test called transcutaneous oximetry helps predict if patients, who undergo surgery to remove soft tissue sarcoma, will face wound-healing complications due to the pre-surgery radiation.

Soft tissue sarcomas are the cancers that initiate in soft tissues like in muscles, fat, blood vessels, nerves and tendons. As a part of its treatment, patients receive external beam radiation. Most often the patients' health gets better and they need less radiation when radiation is administered prior to the surgery. But administering radiation prior to the surgery gradually ups the risk of wound-healing complications.

In the latest study, researchers at the Loyola University Medical Center found that nearly 35 percent of those who undergo surgery to remove the soft tissue sarcomas suffer from wound-healing complications. But, these patients can now be identified with a simple test.

The transcutaneous oximetry test will help surgeons take extra precautions towards the patients who are at a higher risk of facing such complications. Being a non-invasive test, transcutaneous oximetry measures the levels of oxygen of tissue beneath the skin. The adhesive sensors are placed on the skin; the sensors have electrodes that can sense oxygen. This test does not cause side effects or discomfort to the patient.

In this study, the researchers focused on 10 patients who underwent surgery for soft tissue sarcomas after receiving radiation. Those who had lower transcutaneous oxygen levels prior to the surgery were more vulnerable to having wound-healing complications. Nearly 4 out of 7 patients with levels lower than 25 mm Hg just prior to the surgery had complications, while all the three patients with oxygen levels higher than 25 mm Hg healed without any complications.

Since the study was conducted on a small group, the researchers demand the need for further study to confirm the finding. If further study confirms this, then this new simple test would be the apt tool to predict which patients are at maximum risk for wound-healing complications.

Extra precaution is needed to avoid complications like increasing the time interval between radiation and surgery and performing additional tissue transfers and vacuum-assisted closure.

"Transcutaneous oximetry represents a potential tool for decisions regarding surgical timing or potentially other medical and surgical efforts to diminish wound complications," said lead author Lukas Nystrom and co-author Benjamin Miller. "However, given this small sample size, more data is needed to further assess the relationship."

The finding was presented during the annual meeting of the Musculoskeletal Tumor Society.