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Low oxygen in skin may signal higher complication risk after sarcoma treatment
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LAS VEGAS — Complications from pre-operative radiation of soft tissue sarcoma can be predicted by transcutaneous oximetry to allow for interventions, according to research presented here.
Lukas M. Nystrom, MD, presented findings from a small, prospective, pilot study at the American Academy of Orthopaedic Surgeons Annual Meeting. He and colleagues studied 10 patients with lower extremity sarcoma and attempted to predict which patients exposed to radiation would experience complications during healing based on cutaneous oxygen levels present in the patients before they underwent surgical treatment.
Cutaneous oxygen levels were measured before radiation and therapy. The patients with lower extremity sarcoma were exposed to a typical dose of 50 Gy radiation and their tumors had an average size of 15 cm.
Three patients developed serious complications that required additional surgery and skin resection. A fourth patient presented draining complications that required dressing changes for 3 months. Nystrom said that while healing overall was unpredictable, a threshold of 25 mm Hg of oxygen was predictive of fewer complications during the healing process. Compared to patients who had healing complications, patients with uneventful healing showed a higher oxygen threshold that was 10 mm Hg greater, on average.
When asked what steps could be taken in patients with low oxygen levels, Nystrom said further exploration is required into potential preoperative and postoperative management strategies used in patients with low preoperative cutaneous oxygen. – by Shirley Pulawski
Reference:
Nystrom NL, et al. Paper #142. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.
Disclosure: The researchers report no relevant financial disclosures.