Simple Test May Predict Surgical Wound Healing Complications

As many as 35 percent of patients who undergo surgery to remove soft tissue sarcomas experience wound-healing complications, due to radiation they receive before surgery. Now a study has suggested that a simple test called transcutaneous oximetry may be able to predict which of these patients are most likely to experience wound-healing complications, potentially enabling surgeons to take extra precautions.

A study suggest that simple test may be able to predict
which patients are most likely to experience
wound-healing complications.
Soft tissue sarcomas are cancers that originate in the soft tissues, such as muscles, fat, blood vessels, nerves and tendons. External beam radiation typically is part of the treatment regimen. Patients often do better, and require less radiation, when radiation is administered before surgery. But administering radiation before surgery also increases the risk of wound-healing complications.

Transcutaneous oximetry is a noninvasive test that measures the oxygen level of tissue beneath the skin. Adhesive sensors are placed on the skin; the sensors contain electrodes that can sense oxygen. The test causes no side effects or discomfort to the patient.  The study followed ten patients who underwent surgery for soft tissue sarcomas after receiving radiation treatment. Patients with lower transcutaneous oxygen levels before surgery were more likely to experience wound complications. Four of the seven patients who had levels lower than 25 mm Hg just before surgery experienced wound complications, while all three patients with oxygen levels higher than 25 mm Hg healed without difficulty.

The study population is small, and further work is necessary to confirm the findings. If confirmed by further study, transcutaneous oximetry potentially could become a tool to predict which patients are most at risk for wound complications. Extra precautions then could be taken to prevent complications, such as increasing the time interval between radiation and surgery and performing additional tissue transfers and vacuum-assisted closure.