{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:59:23Z","timestamp":1792727963408,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,8,25]],"date-time":"2018-08-25T00:00:00Z","timestamp":1535155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n                    Background: Obesity is a known risk factor for wound complications; however, unlike elective upper extremity procedures, where obesity can be modified preoperatively, excision of soft tissue sarcomas (STSs) is not elective, and as such, obesity cannot be modified. There is a paucity of data concerning the impact of obesity on wound healing in upper extremity sarcoma surgery. Methods: A total of 261 (159 males and 102 females) patients with a STS of the upper extremity from 2006-2014 were reviewed. The mean age and body mass index (BMI) were 56 (18-97) years and 26.6 (15.4-40.8) kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , respectively. Sixty-nine patients (26%) were classified as obese (BMI \u2a7e30 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ): class I (obese, BMI = 30-34.9 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ; n = 48, 18%), class II (severely obese, BMI = 35.0-39.9 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ; n = 16, 6%), and class III (morbidly obese, BMI \u2265 40 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ; n = 5, 2%). Functional outcomes were also compared between obese and nonobese patients using the Musculoskeletal Tumor Society (MSTS) 1993 rating system and Toronto Extremity Salvage Scores (TESS). Results: Forty-nine patients (19%) sustained a wound dehiscence, delayed healing, or infection. Class III obesity increased the risk of wound complications (hazard ratio [HR] = 8.19, 95% confidence interval [CI] = 1.96-22.96, P &lt; .001) and infection (HR = 10.09, 95% CI = 1.60-34.83, P = .01). There was no difference in the mean TESS (93 vs 90, P = .13) or MSTS93 (95 vs 93, P = .39) between obese and nonobese patients. Conclusions: The results of this study indicate morbid obesity significantly increased the risk of a postoperative wound complication and infection. However, following upper extremity limb salvage surgery, obese patients should expect to have excellent functional outcome.\n                  <\/jats:p>","DOI":"10.1177\/1558944718797336","type":"journal-article","created":{"date-parts":[[2018,8,25]],"date-time":"2018-08-25T03:06:55Z","timestamp":1535166415000},"page":"114-120","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Morbid Obesity Increases the Risk of Postoperative Wound Complications, Infection, and Repeat Surgical Procedures Following Upper Extremity Limb Salvage Surgery for Soft Tissue Sarcoma"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0390-1018","authenticated-orcid":false,"given":"Matthew T.","family":"Houdek","sequence":"first","affiliation":[{"name":"University of Toronto, ON, Canada"},{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Griffin","sequence":"additional","affiliation":[{"name":"University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay S.","family":"Wunder","sequence":"additional","affiliation":[{"name":"University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,8,25]]},"reference":[{"key":"bibr1-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199109000-00015"},{"key":"bibr2-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-0915-5"},{"key":"bibr3-1558944718797336","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200901000-00006"},{"key":"bibr4-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09292-9"},{"key":"bibr5-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e3180514c50"},{"key":"bibr6-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2014.10.045"},{"key":"bibr7-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199404001-00012"},{"key":"bibr8-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24357"},{"key":"bibr9-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2017.01.016"},{"key":"bibr10-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2016.11.055"},{"key":"bibr11-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2013.07.043"},{"key":"bibr12-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.12.008"},{"key":"bibr13-1558944718797336","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.00255"},{"key":"bibr14-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.05.046"},{"key":"bibr15-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2004.243"},{"key":"bibr16-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.1.350"},{"key":"bibr17-1558944718797336","first-page":"241","author":"Enneking WF","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"bibr18-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1007\/BF00540024"},{"key":"bibr19-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2797-1"},{"key":"bibr20-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22298"},{"key":"bibr21-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2001.1213"},{"key":"bibr22-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/829498"},{"key":"bibr23-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9028-6"},{"key":"bibr24-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1186\/s13569-016-0041-7"},{"key":"bibr25-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-014-3714-7"},{"key":"bibr26-1558944718797336","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00515"},{"key":"bibr27-1558944718797336","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01935"},{"key":"bibr28-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2009.05.016"},{"key":"bibr29-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4283-0"},{"key":"bibr30-1558944718797336","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.01289"},{"key":"bibr31-1558944718797336","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001591"},{"key":"bibr32-1558944718797336","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-22-03-193"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944718797336","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944718797336","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944718797336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:29:08Z","timestamp":1777447748000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944718797336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,25]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1177\/1558944718797336"],"URL":"https:\/\/doi.org\/10.1177\/1558944718797336","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,25]]}}}