Wound‐Healing Complications Disrupt Early Patient‐Reported Recovery After Limb‐Sparing Soft Tissue Sarcoma Surgery
Riley A. O'Toole, Precious Oyem, Nathan W. Mesko, Zachary D. Burke, Andre Spiguel, Jeremy White, Benjamin J. Miller, Lukas M. NystromABSTRACT
Background and Objectives
Wound‐healing problems, both minor events and major wound‐healing complications (WHCs), are common after soft tissue sarcoma (STS) surgery. Their impact on patient‐reported recovery remains poorly defined. This study evaluated associations between postoperative WHCs and PROMIS physical and mental health outcomes.
Methods
We performed a retrospective analysis of a prospectively collected, multi‐institutional cohort of adults undergoing limb‐sparing resection for extremity or trunk STS (2017–2025). Wound‐healing events were recorded, and major WHCs were defined as complications requiring return to the operating room. PROMIS Global Physical Health and Global Mental Health T‐scores were obtained preoperatively and at 3 and 6 months. Cross‐sectional scores, change from baseline, and responder analyses (≥ 3‐point improvement) were compared by WHC status.
Results
Of 74 patients, 45 (60.8%) experienced a wound‐healing event and 16 (21.6%) developed a major WHC requiring reoperation. Baseline PROMIS scores were similar between groups. At 3 months, patients with wound‐healing events had significantly worse physical and mental health recovery trajectories. Early events and reoperation were associated with worse physical function through 6 months.
Conclusions
Postoperative wound‐healing events, particularly early or major complications, are associated with clinically meaningful disruptions in patient‐reported recovery, supporting the value of PROMIS‐based postoperative monitoring.