Large, deep high-grade extremity sarcomas: when is a myocutaneous flap reconstruction necessary?

The surgical treatment of large, deep high-grade extremity soft tissue sarc omas frequently produces a significant tissue defect. In addition, the mana gement of the surgical wound is often further complicated by preoperative r adiation or adjuvant therapies. The use of either pedicled or free myocutan eous flaps allows for more rapid and predictable wound healing in this situ ation. Myocutaneous flaps provide well-vascularized coverage of lost tissue volume, exposed vital structures, and prosthetic reconstruction materials. When harvested from unirradiated sites, flap coverage can overcome the det rimental effects of radiation therapy and chemotherapy on postoperative wou nd healing. Reconstruction of the soft tissue defect map also improve patie nt satisfaction with aesthetic issues. The use of innervated myocutaneous f laps can even address the functionality of the extremity following resectio n of major muscle groups. Myocutaneous flaps are an extremely versatile opt ion for reconstruction in the treatment of large, deep high-grade extremity soft tissue sarcomas. (C) 2000 Elsevier Science Ltd. All rights reserved.