SOFT-TISSUE RECONSTRUCTION FOLLOWING HEMIPELVECTOMY

BACKGROUND: Resection of primary and metastatic pelvic bone disease ma y result in large soft tissue deficits. Guidelines for soft tissue rec onstruction following pelvic bone resection were evaluated in a retros pective study. METHODS: Over a 5-year period 21 patients (31%) require d soft tissue reconstruction following pelvic bone resection. Data on these patients were retrieved from case records. RESULTS: Twelve patie nts underwent immediate, planned reconstruction, 1 a two-stage reconst ruction, and 8 patients required a delayed procedure for complications after bone resection and primary closure. Soft tissue reconstruction was usually accomplished with muscle-based flaps; (25 flaps in 20 pati ents: 20 pedicled, 5 free), or with skin grafts alone (1 patient). Spe cific postreconstruction complications occurred in 9 patients, 5 in fl aps based on the ipsilateral rectus muscle. CONCLUSION: Flap closure i s indicated to achieve primary closure and eliminate deadspace. The ip silateral rectus muscle should be used with caution and contralateral- based rectus flaps considered. Indications for free flaps include the size and location of the defect and availability of tissue from an amp utated limb. (C) 1998 by Excerpta Medica, Inc.