Erschienen in:
01.05.2006 | Editorial
The Evolution of Extremity Reconstruction for Soft Tissue Sarcoma
verfasst von:
Grant W. Carlson, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 5/2006
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Excerpt
The current management of soft tissue and bone sarcomas includes radiation, surgery, and often chemotherapy. Limb salvage surgery has become the standard approach for extremity sarcomas after trials showed survival equivalence to amputation. Reconstruction has evolved to include alloplastic materials for joint and bone replacement and vascular reconstruction, as well as free tissue transfer to provide stable soft tissue coverage, vascularized bone, and functioning muscle replacement. Flap reconstruction has numerous advantages over primary wound closure. It allows larger resections and provides vascularized tissue with an independent blood supply. This reduces wound complications, especially in patients receiving preoperative radiotherapy. Wound complication rates range from 25% to 44% for soft tissue sarcomas resected in the setting of radiotherapy.
1‐
4 Barwick et al.
2 reported on 82 patients with soft tissue sarcomas who were treated with preoperative radiation. Thirty-seven patients underwent primary wound closure, and 41 patients required a vascularized tissue flap. The use of a flap resulted in a lower complication rate (19% vs. 51%), fewer secondary procedures (10% vs. 35%), a shorter hospital stay (15 vs. 48 days), and improved limb salvage (97% vs. 91%). …
