Soft Tissue Reconstruction in Limb-Sparing Tumor Surgery

Abstract

Limb-sparing surgery for bone and soft tissue sarcomas has become more widespread along with the development of adjuvant therapy and several kinds of imaging techniques for analyzing local tumor extension [1]. This procedure can be indicated for surgical treatment of the tumor, unless a major neurovascular structure is involved by the tumor, although vascular reconstruction may be possible in order to achieve an adequate margin [2]. However, the incision is sometimes too extensive to be closed directly after a particularly wide excision of the tumor and, furthermore, resection of muscles following tumor excision might result in a certain loss of function of the extremity. As a result, soft tissue reconstruction is regarded as the keystone of extending the indication for limb-salvage surgery and achieving favorable use of the extremities. While others have reported the use of pedicle flaps for wound coverage with satisfactory results [3, 4], the authors have been applying micro-surgical tissue transfer for soft tissue reconstruction in limb-sparing tumor surgery. The selection of flaps depends on the size and content of the soft tissue defects. From our experience, the results are encouraging, and a much lower complication rate and better limb function can be expected.