Obesity increases the risk of major wound complications following pelvic resection for bone sarcoma

Author:

Wang Patrick Qi12ORCID,Gazendam Aaron12ORCID,Ibe Izuchukwu3,Kim Noel1,Alfaraidy Meshal12,Eastley Nicholas12,Griffin Anthony2,Wunder Jay12,Ferguson Peter12,Tsoi Kim12

Affiliation:

1. Department of Surgery University of Toronto Toronto Ontario Canada

2. Department of Surgery, Sinai Health System, Mount Sinai Hospital, Division of Orthopaedic Surgery University of Toronto Musculoskeletal Oncology Unit Toronto Ontario Canada

3. Department of Orthopaedics and Rehabilitation University of Mississippi Medical Center Jackson Mississippi USA

Abstract

AbstractBackgroundGiven the paucity of data, the objective of this study is to evaluate the association between obesity and major wound complications following pelvic bone sarcoma surgery specifically.MethodsPatients who underwent pelvic resection for bone sarcoma from 2005 to 2021 with a minimum 6‐month follow‐up were reviewed. Patients with benign tumors, primary soft tissue sarcomas, local recurrence at presentation, pelvic metastatic disease, and underweight patients were excluded. A major wound complication was defined as the need for a secondary debridement procedure. Differences in baseline demographics, surgical factors, postoperative complications, and functional outcomes were compared between obese and nonobese patients. A multivariate logistic regression was performed to identify independent risk factors for major wound complications, and a Kaplan–Meier analysis to estimate overall survival between both groups.ResultsOf the 93 included patients, 21 were obese (body mass index ≥ 30 kg/m2). The obesity group had a significantly higher rate of major wound complication (52% vs. 26%, p = 0.034) and a lower Toronto Extremity Salvage Score at 1‐year postoperatively (47.5 vs. 71.4, p = 0.025). Obesity was the only independent risk factor in the multivariate analysis. No differences in overall survival were demonstrated between groups.ConclusionsObesity is a significant risk factor for major wound complications in pelvic bone sarcoma treatment. This highlights the importance of careful perioperative optimization and wound management.

Publisher

Wiley

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