Skin and Muscle Closure Techniques Following Large-Scale Osteosarcoma Removal: A Comparative Analysis.

Autor:	Meretsky CR; Surgery, St. George's University School of Medicine, Great River, USA., Krumbach B; Anatomy, St. George's University, Great River, USA., Popovich J; Internal Medicine, St. George's University School of Medicine, Great River, USA., Ajebli M; Biology Sciences, Moulay Ismail University, Faculty of Sciences and Technologies, Errachidia, MAR., Schiuma AT; Orthopedic Surgery, Holy Cross Hospital, Fort Lauderdale, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 10; Vol. 16 (7), pp. e64258. Date of Electronic Publication: 2024 Jul 10 (Print Publication: 2024).
DOI:	10.7759/cureus.64258
Abstrakt:	Osteosarcoma (OS), the most prevalent form of bone cancer, typically arises in osteoblast cells responsible for generating new bone. The bone produced by these cancer cells is weaker compared to healthy bone. OS is an aggressive bone cancer that often requires extensive resection, leaving behind substantial soft tissue defects. Successful closure after tumor excision is critical for wound healing and postoperative recovery. However, the optimal approach varies depending on factors like defect size and location. After extensive resection of OS, restoring the integrity of the affected area demands careful closure of both the skin and underlying muscle. The appropriate closure technique depends on the size and location of the soft tissue defect. The main objective of this systematic review is to evaluate and compare different surgical techniques for closing skin and muscle layers following large-scale OS removal. Through a systematic review methodology, we conducted an extensive analysis of the existing body of literature on this topic, drawing from relevant research papers published over the past two decades. This allowed us to collectively evaluate and synthesize available data on the subject. This review found that negative pressure wound therapy (NPWT) and flap reconstruction are the main surgical approaches used to close skin and muscle following extensive OS resection, which commonly results in large soft tissue defects due to the nature of tumor removal. Furthermore, NPWT was the most widely used method for closing soft tissue defects after major OS removal, while flap reconstruction was also common when NPWT was not appropriate or the defect was too large. An integrated approach combining vacuum therapy, skin stretching, and occasional flaps seeks to primarily close large defects after OS resection through optimized healing and tension reduction to achieve the best postoperative results. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Meretsky et al.)
Databáze:	MEDLINE
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