It is sometimes possible to avoid amputation of the limb by using free flaps for the repair of defects of the limbs following exeresis of sarcomas. In fact it is now ascertained that if surgical therapy for sarcomas is to be radical and capable of preventing relapses, it must be as extensive as possible. The first flaps used by us for these extensive reconstructions were flaps of the great dorsal, of the recto-abdomen and of the serrate. At present, we are using fascicle cutaneous free flaps more and more, based on perforated arteries and in particular, DIEP flaps (Deep Inferior Epigastric Perforator Flap) and Antero-Lateral of the thigh (ALT). The latter have a number of advantages in relation to the muscular flaps: they are malleable and versatile in many reconstructive cases and moreover, because they are thin and remain soft for a long time, it is possible to notice an eventual local relapse in time; they do not affect the muscular plane: they leave the muscular function of the donating area whole; they present a long vascular peduncle which makes the flap very mobile; they have an increased vascularization and they do not require a longer preparation time in relation to the traditional free flaps. The main disadvantage of perforated flaps is that a certain amount of experience is required to prepare them. The case records presented concern the Plastic and Reconstructive Surgery Dept., from 1992 to the present day: 10 patients affected with sarcomas, 2 of the upper limbs and 8 of the lower limbs, aged between 21 and 45 years, 6 men and 4 women, underwent extended exeresis operation of the neoplasm and immediate repair of the loss of the residual substance by means of free flaps. For immediate reconstruction, we initially opted for the great dorsal, for the recto-abdomen and serrate flaps. Lately however, we are using fascicle cutaneous flaps more and more, based on perforated arteries, such as DIEP and the Antero-Lateral of the thigh. We indeed believe that these latter ones should be considered a first-quality choice in this type of reconstruction, by virtue of their excellent characteristics.
|Translated title of the contribution||New flaps in post-oncologic reconstructive surgery of the limbs|
|Number of pages||7|
|Journal||Rivista Italiana di Chirurgia Plastica|
|Publication status||Published - 1999|
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