Surgery for sarcoma in Sheffield
Mr Morritt is a sarcoma specialist based in Sheffield. He is a core member of the Sheffield regional sarcoma unit multidisciplinary team. Additionally, Mr Morritt is the plastic surgery lead clinician for the sarcoma service. He regularly operates on patients with all forms of soft tissue sarcoma (excluding disease in bone and the retroperitoneum). Mr Morritt’s personal expertise extends to treating patient’s with disease in the upper limbs, lower limbs, and trunk. Consultations and surgery are undertaken at the Royal Hallamshire Hospital in Sheffield.
What is sarcoma?
Sarcoma is a rare cancer that can develop in any part of the body. It occurs most frequently in the limbs and can arise from muscle and fat but can also arise from many different types of tissues such as nerves, bones, blood vessels etc
Symptoms of soft tissue sarcomas
Soft tissue sarcomas usually present as a lump under the skin. The lump is most frequently located on the limbs or trunk. Lumps with the following characteristics should be considered suspicious for sarcoma and investigated appropriately to establish a diagnosis.
- larger than 5 cm
- increasing in size
- usually painful (although not always)
- situated deeper inside the tissue
How are soft tissue sarcomas diagnosed?
Patient’s who have noticed a lump should consult their GP. If sarcoma is suspected after an examination of the lump further tests can be carried out including:
- MRI scan
- Ultrasound guided biopsy
Once the diagnosis is confirmed, some patients will also need a CT scan of the chest to look for spread of disease.
Treatment of soft tissue sarcomas
Depending on the type and grade of disease, treatment can include:
- surgery – usually the first treatment
Reconstructive surgery for sarcoma
The majority of sarcomas can be removed without the need for complex reconstructive surgery. Aggressive (fast growing cancers) often require more extensive surgery. In some cases this may require reconstructive surgery. Mr Morritt offers all plastic surgery reconstructive options following sarcoma excision including:
Split thickness skin grafting
A thin piece of skin (tissue paper thickness) is used to cover the wound following surgical removal of the sarcoma. This kind of skin graft is taken most frequently from the thigh leaving a raw wound much like a graze which takes two weeks to heal.
Full thickness skin grafting
Full thickness skin grafts are thicker than a split skin graft and therefore more robust. Full thickness skin grafts are also more stretchy than split skin grafts and therefore useful for covering wounds over joints etc. Another benefit of full thickness skin grafts is that they tend to look much more similar to normal skin than split skin grafts and are therefore the preferred choice for covering defects on the face.
Dermal substitutes e.g. Matriderm ®, Integra ®
Combining dermal substitutes with split skin graft makes the reconstructed skin more supple and robust and improves the cosmetic outcome.
Tissue is moved on a pedicle (attachment to the body) to fill the hole after the tumour has been removed.
Free tissue transfer (Free flap surgery; microsurgery)
This is where tissue from one area is transferred to another area to rebuild it. The surgery is complex and involves reestablishing the blood supply to the transferred tissue using microsurgical techniques. Mr Morritt has extensive experience in undertaking these complex reconstructions having trained with internationally recognised experts in Melbourne, Toronto and London.
Sarcoma multidisciplinary team (MDT), Sheffield
Research and experience have shown that the best outcomes for treatment require a multidisciplinary approach. This allows each patient’s treatment to be customised according to the recommendations of experts in radiology, pathology, surgery and oncology. The Sheffield Regional Sarcoma MDT consists of plastic surgeons and retroperitoneal surgeons, radiologists, oncologists, pathologists and clinical nurse specialists. The team meets every week on Thursday morning at Western Park Hospital in Sheffield to discuss new referrals and the patient’s having follow-up under our care.
To contact the MDT coordinator:
Telephone – 0114 2712513
Email – sht-tr.Cancer-Sarcoma@nhs.net
Sarcoma referrals to Mr Morritt
Referrals from general practice should be on an urgent 2 week wait basis to the plastic surgery service (please specify Mr Morritt), using the dedicated 2 week wait proforma which is available to all GPs. The referral should be made after urgent investigation of a suspicious soft tissue mass with an ultrasound scan as per current NICE guidelines.
Referrals from hospital specialists/secondary care should be made on a Sheffield Sarcoma MDT proforma, which is available to all Trusts within the region. The referrals should be emailed directly to sht-tr.Cancer-Sarcoma@nhs.net. Any queries about a referral can also be made to that address.
Also, please note that it is essential that you inform your patient about the referral. Similarly, please explain the need for further investigations such as biopsy or further imaging tests.
Links to sarcoma websites
Read more: Information guide (BAPRAS)