在腹股沟区切除软组织肉瘤与显著并发症有关。为了闭合创口，常常使用游离/带蒂皮瓣，但它们对愈合的影响不明确。我们比较了接受皮瓣重建或初级闭合手术治疗腹股沟肉瘤的患者的创口并发症、肿瘤学和功能结果。共有177位患者接受了腹股沟肉瘤切除手术，其中一些采用了初级闭合（PrC），一些则采用了游离/带蒂皮瓣重建（FR）。对比了患者、肿瘤和治疗特点，以及创口并发症、肿瘤学结果和功能结果（TESS/MSTS87/MSTS93）。为了检查皮瓣重建的相对益处，计算了需要治疗的患者数（NNT）。 总共有143位患者接受了PrC手术，有34位接受了FR手术，其中68%采用了带蒂皮瓣。人口统计学、肿瘤或治疗特征方面几乎没有什么差异。创口并发症率没有显著差异。住院时间在FR手术中明显更长（18天vs. PrC 8天，p <0.01）。在5年的随访期内，肿瘤学和功能结果相似。对于 ≥15厘米的肿瘤（NNT = 8.4）或容积 ≥800 ml 的肿瘤（NNT = 8.4），FR手术中未合并创口愈合的比例比PrC手术更高。 ≤336 ml的肿瘤不需要采用皮瓣重建，而> 600 ml的肿瘤皮瓣闭合后愈合顺利的可能性增加1.5倍。 虽然使用皮瓣会延长住院时间，但它可减少较大肿瘤的创口愈合并发症，在所有大小肿瘤中，它的功能和肿瘤学结果与初级闭合手术相似。我们的基于大小的治疗标准可帮助识别有益于皮瓣重建的大腹股沟肉瘤患者。（回顾性队列研究）。©2023年。外科肿瘤学会。

Resection of soft-tissue sarcomas from the adductor compartment is associated with significant complications. Free/pedicled flaps often are used for wound closure, but their effect on healing is unclear. We compared wound complications, oncologic, and functional outcomes for patients undergoing flap reconstruction or primary closure following resection of adductor sarcomas.A total of 177 patients underwent resection of an adductor sarcoma with primary closure (PrC) or free/pedicled flap reconstruction (FR). Patient, tumor, and treatment characteristics were compared, as well as wound complications, oncologic, and functional outcomes (TESS/MSTS87/MSTS93). To examine the relative benefit of flap reconstruction, number needed to treat (NNT) was calculated.In total, 143 patients underwent PrC and 34 had FR, 68% of which were pedicled. There were few differences in demographic, tumor, or treatment characteristics. No significant difference was found in the rate of wound complications. Length of stay was significantly longer in FR (18 days vs. PrC 8 days; p < 0.01). Oncologic and functional outcomes were similar over 5 years follow-up. Uncomplicated wound healing occurred more often in FR compared with PrC for tumors with ≥15 cm (NNT = 8.4) or volumes ≥ 800 ml (NNT = 8.4). Tumors ≤ 336 ml do not benefit from a flap, whereas those > 600 ml are 1.5 times more likely to heal uneventfully after flap closure.Although flap use prolonged hospitalization, it decreased wound healing complications for larger tumors, and in all sized tumors, it demonstrated similar functional and oncologic outcomes to primary closure. Our size-based treatment criteria can help to identify patients with large adductor sarcomas who could benefit from flap reconstruction.(Retrospective cohort study).© 2023. Society of Surgical Oncology.