Locoregional Flaps in Oncoreconstruction at a Tertiary Cancer Centre in North East India: a Review Through a Plastic Surgeon’s Eye

Abstract

Local flaps are important parts of oncoreconstruction. The idea of writing this article is to give knowledge to my fellow aspiring plastic surgeons about the common locoregional flaps that are essentially done in a tertiary cancer centre. This is a retrospective study carried out in the Department of Plastic Surgery, Dr. B Borooah Cancer Institute, Guwahati, from May 2018 to April 2019. Musculoskeletal and soft tissue, head and neck and thorax and gynaecological malignancies which required locoregional flaps for reconstruction were taken up for the study. Flap reconstructions performed by oncosurgeons are not included in the study. We have done a total of 74 locoregional reconstructions during this 12-month period apart from 43 free tissue transfers. In our study, age ranged from 12 to 84 years. Most commonly performed flap during this time was pectoralis major myocutaneous flap. Complications of various flaps were assessed. Out of the 74 flaps, total necrosis of one flap occurred, and re-surgery was required in one case. Most of the oncosurgeons have a good idea of locoregional reconstructions in cancer centres. In such centres, the need of plastic surgeon for locoregional reconstruction is mainly for complex reconstructions and unfamiliar anatomic locations, for second flap after initial local flap failure or after free flap–related complications.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. 1.

    Hasen KV, Few JW, Fine NA (2002) Plastic surgery: a component in the comprehensive care of cancer patients. Oncology (Williston Park) 16(12):1685–1698 discussion 1698, 1702–5, 1708

    Google Scholar 

  2. 2.

    Vartanian JG, Carvalho AL, Carvalho SM, Mizobe L, Magrin J, Kowalski LP (2004) Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: experience with 437 cases at a single institution. Head Neck 26(12):1018–1023 [Ref list]

    Article  Google Scholar 

  3. 3.

    McCrory AL, Magnuson JS (2002) Free tissue transfer versus pedicled flap in head and neck reconstruction. Laryngoscope 112:2161–2165 [Google Scholar]

    Article  Google Scholar 

  4. 4.

    Netterville JL, Panje WR, Maves MD (1987) The trapezius myocutaneous flap, dependability and limitations. Arch Otolaryngol Head Neck Surg. 113(3):271–281

    CAS  Article  Google Scholar 

  5. 5.

    Barton FE Jr, Spicer TE, Byrd HS (1983) Head and neck reconstruction with the latissimus dorsi myocutaneous flap: anatomic observations and report of 60 cases. Plast Reconstr Surg. 71(2):199–204

    Article  Google Scholar 

  6. 6.

    Zeifang F, Bernd L (2003) Orthopaedic Clinic of the University of Heidelberg, Schlierbacher Landstrasse 200a, D-69118 Heidelberg, Medial gastrocnemius muscle flap in limb-sparing surgery of malignant bone tumors of the proximal tibia: mid-term results in 25 patients. Buchner M1, Germany. Ann Plast Surg. 51(3):266–272

    Article  Google Scholar 

  7. 7.

    Larrañaga JJ, Picco PI, Yanzon A, Figari M (2017) Published online 2017 Aug 3. Reconstruction of hind and mid-foot defects after melanoma resection using the reverse sural flap: a case series. Surg J (N Y) 3(3):e124–e127

    Google Scholar 

  8. 8.

    Grabbs encyclopaedia of flaps (third edition), volume 3: torso, pelvis and lower limb chapter 517 ;page 1481–90

  9. 9.

    Wangensteen OH (1934) Repair of recurrent and difficult hernias and other large defects of the abdominal wall employing the iliotibial tract of fascia lata as a pedicled flap. Surg Gynecol Obstet 59:766–780 [Google Scholar]

    Google Scholar 

  10. 10.

    Nahai F, Hill HL, Hester TR (1979) Experiences with the tensor fascia lata flap. Plast Reconstr Surg 63:788–799 [CrossRef] [Google Scholar]

    CAS  Article  Google Scholar 

  11. 11.

    Murthy V, Gopinath KS (2012) Reconstruction of groin defects following radical inguinal lymphadenectomy: an evidence based review. Indian J Surg Oncol 3(2):130–138 Published online 2012 Mar 28

    Article  Google Scholar 

  12. 12.

    Song YG, Chen GZ, Song YL (1984) The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 37:149 [CrossRef] [Google Scholar]

    CAS  Article  Google Scholar 

  13. 13.

    Koshima I, Fukuda H, Utonomiya R et al (1989) The anterolateral thigh flap: variations in its vascular pedicle. Br J Plast Surg 42:260 [CrossRef] [Google Scholar]

    CAS  Article  Google Scholar 

  14. 14.

    Bakri K, Mardini S, Evans KK, Carlsen BT, Arnold PG, Guest Editors Karen K. Evans, M.D. Samir Mardini, M.D. Phillip G. Arnold, M.D (2011) Chest wall reconstruction, workhorse flaps in chest wall reconstruction: the pectoralis major, latissimus dorsi, and rectus abdominis flaps. Semin Plast Surg 25(1):43–54

    Article  Google Scholar 

  15. 15.

    Yii NW, Niranjan NS (1996) Lotus petal flaps in vulvo-vaginal reconstruction. Br J Plast Surg 49(8):547–554

    CAS  Article  Google Scholar 

Download references

Acknowledgements

No financial support or sponsorship of any kind is obtained.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Sumanjit S. Boro.

Ethics declarations

Conflict of Interest

The authors declare that there is no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Boro, S.S., Das, A.K., Purakayastha, J. et al. Locoregional Flaps in Oncoreconstruction at a Tertiary Cancer Centre in North East India: a Review Through a Plastic Surgeon’s Eye. Indian J Surg Oncol (2020). https://doi.org/10.1007/s13193-020-01151-1

Download citation

Keywords

  • Local flap,
  • Oncoreconstruction,
  • Plastic surgeon