Immediate soft-tissue reconstruction using a rectus abdominis myocutaneous flap following wide resection of malignant bone tumours of the pelvis

Soft-tissue reconstruction following preoperative radiotherapy and wide resection of soft tissue sarcoma remains a challenge. Pedicled and free tissue transfers are an essential part of limb sparing surgery. We report 22 cases of sarcoma treated with radiotherapy and wide excision followed by one-stage innervated free or pedicled musculocutaneous flap transfers. The resection involved the upper limb in 3 cases, the lower limb in 17, and the abdominal wall in 2. The flaps used for the reconstruction were mainly latissimus dorsi and gracilis. The range of motion was restored fully in 14 patients. The muscle strength of the compartment reconstructed was of grades 4 and 5 in all patients except one. The overall function was excellent in all the cases with functional scores of 71.2% in the upper limb and 84% in the lower limb. The only 2 major complications were flap necrosis, both revised with another flap, one of which was innervated with restoration of function. Innervated flaps are valuable alternatives for reconstruction after sarcoma resection in the extremity and in the abdominal wall. The excellent functional results are encouraging, and we believe that innervated muscle reconstruction should be encouraged in the treatment of sarcoma after radiotherapy and wide resection.

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Delayed Soft Tissue Reconstruction with a Horizontal Rectus Abdominis Musculocutaneous Flap following Hip Exarticulation

Case Reports in Surgery ◽

10.1155/2013/670304 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3

Author(s):

Jes Christian Rødgaard ◽

Troels Michael Tei

Keyword(s):

Soft Tissue ◽

Rectus Abdominis ◽

Successful Outcome ◽

Soft Tissue Reconstruction ◽

Necrotic Tissue ◽

Soft Tissue Defects ◽

Future Planning ◽

Tissue Reconstruction ◽

The Right ◽

Tissue Defects

Coverage of large soft tissue defects at the hip region constitutes a challenge for plastic surgeons. We report the case of a 43-year-old female with necrotizing fasciitis of the right thigh, necessitating hip exarticulation and substantial debridement of necrotic tissue. An ipsilateral horizontal rectus abdominis myocutaneous (HRAM) flap was used to cover the defect. The reconstruction was carried out after the attempt of local tissue rearrangement. In light of the successful outcome, we propose that this flap be considered in the future planning of soft tissue reconstruction at the hip region.

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Soft tissue reconstruction of the breast using an extended composite latissimus dorsi myocutaneous flap

British Journal of Plastic Surgery ◽

10.1016/0007-1226(84)90080-8 ◽

1984 ◽

Vol 37 (3) ◽

pp. 361-368 ◽

Cited By ~ 35

Author(s):

Donald R. Marshall ◽

E. John Anstee ◽

Murray J. Stapleton

Keyword(s):

Soft Tissue ◽

Latissimus Dorsi ◽

Myocutaneous Flap ◽

Soft Tissue Reconstruction ◽

Latissimus Dorsi Myocutaneous Flap ◽

Tissue Reconstruction

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Tricks and pitfalls in the surgical treatment of malignant bone tumours of the forearm in children and adolescents

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.15.210133 ◽

2021 ◽

Vol 15 (4) ◽

pp. 366-371 ◽

Cited By ~ 1

Author(s):

Bulent Erol ◽

Omer Sofulu

Keyword(s):

Surgical Management ◽

Multidisciplinary Approach ◽

Functional Results ◽

Bone Tumours ◽

Soft Tissue Reconstruction ◽

Unique Region ◽

Reconstruction Methods ◽

Malignant Bone Tumours ◽

Tissue Reconstruction ◽

Bone Sarcomas

Malignant bone tumours around the forearm are rare. Nowadays, oncological and surgical management of bone sarcomas of this region has improved significantly. Although the anatomical features are complex, limb-sparing surgery is possible with wide surgical resection. Biological reconstruction methods are promising in this anatomically unique region. In addition, meticulous soft-tissue reconstruction yields good functional results in the hand and wrist. This study reviews malignant bone tumours of the forearm and their oncological and surgical management. Malignant bone tumours should be treated with a multidisciplinary approach based on chemotherapy, radiotherapy and limb salvage procedures.

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