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SarcomaVolume 2012 2012, Article ID 315190, 8 pages

Research Article

Department of Plastic Surgery, St. Vincent’s Hospital, Melbourne, Fitzory, VIC 3065, Australia

Department of Orthopaedics, St. Vincent’s Hospital, University of Melbourne, Level 3, Daly Wing, 41 Victoria Parade, Fitzroy, VIC 3065, Australia

Department of Surgery, The University of Melbourne, Parkville, VIC, Australia

Received 12 June 2012; Accepted 16 July 2012

Academic Editor: Robert Grimer

Copyright © 2012 Damien Grinsell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Autor: Damien Grinsell, Claudia Di Bella, and Peter F. M. Choong



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