ADJUVANT THERAPY - THE EFFECTS ON MICROVASCULAR LOWER-EXTREMITY RECONSTRUCTION

Adjuvant therapy and microsurgery have allowed advances in surgical ex tirpation of lower extremity neoplasms. This retrospective study was d esigned to evaluate the microvascular transfer for lower extremity rec onstruction in patients receiving pre- or postoperative irradiation an d chemotherapy alone and in combination, Over a 5-year period, 24 free tissue transfers were performed in 22 patients undergoing surgical re section with adjuvant therapy for lower extremity neoplasms, There wer e 13 male and 9 female patients with an average age of 51 years, The l atissimus dorsi muscle was most commonly transferred (N = 15), Eightee n tumors received pre- and three received postoperative radiotherapy. Two tumors received a combination of radiotherapy and brachytherapy. P re- and/or postoperative chemotherapy was used in 14 patients. Twelve of these patients had both chemo- and radiation therapy. A total of si x complications occurred, with no flap loss, Complications were evenly distributed among adjuvant regimens. All patients who underwent attem pted limb salvage were able to ambulate postoperatively, except for 1 patient who had local recurrence, In conclusion, adjuvant therapy did not increase the complication rate for free tissue transfer in the low er extremity, Adjuvant therapy did not require alterations in the free tissue transfer and, similarly, free tissue transfer did not alter ad juvant therapy, We believe that free tissue transfer in complicated wo unds allows for better wound healing with adjuvant therapy rather than local or primary wound closure alone.