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

## TL;DR

This paper compares surgical techniques for closing skin and muscle after large osteosarcoma removal, focusing on methods like negative pressure wound therapy and flap reconstruction.

## Contribution

The paper provides a systematic review and comparative analysis of skin and muscle closure techniques after osteosarcoma resection.

## Key findings

- Negative pressure wound therapy (NPWT) is the most widely used method for closing soft tissue defects after osteosarcoma removal.
- Flap reconstruction is commonly used when NPWT is not suitable or the defect is too large.
- An integrated approach combining vacuum therapy, skin stretching, and flaps optimizes healing and reduces tension for large defects.

## Abstract

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.