Limits...
Reconstruction of Radiated Gluteal Defects following Sarcoma Resection with Pedicled Sensate Tensor Fascia Lata Flaps.

Chao AH, Kearns PN - Case Rep Oncol Med (2015)

Bottom Line: Sarcomas of the gluteal region often result in sizable defects following resection that are challenging to reconstruct due to their location, particularly in patients who have received radiation therapy.A pedicled tensor fascia lata (TFL) flap was therefore performed in both cases, which resulted in durable sensate reconstruction with good functional outcomes and no complications.We believe the pedicled TFL flap represents an important option for the reconstruction of oncologic gluteal defects that provides well-vascularized and sensate tissue from outside the zone of radiation without the need for microsurgical techniques.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, The Ohio State University, Columbus, OH 43212, USA.

ABSTRACT
Sarcomas of the gluteal region often result in sizable defects following resection that are challenging to reconstruct due to their location, particularly in patients who have received radiation therapy. Reconstruction of these defects has been seldom discussed in the literature. We present two patients with large radiated gluteal defects following sarcoma resection, of which one patient received neoadjuvant radiation and the other received intraoperative radiation therapy. As a result of the resection and radiation, local tissues and recipient vessels were unsuitable for use in reconstruction. A pedicled tensor fascia lata (TFL) flap was therefore performed in both cases, which resulted in durable sensate reconstruction with good functional outcomes and no complications. We believe the pedicled TFL flap represents an important option for the reconstruction of oncologic gluteal defects that provides well-vascularized and sensate tissue from outside the zone of radiation without the need for microsurgical techniques.

No MeSH data available.


Related in: MedlinePlus

Immediate postoperative result following gluteal reconstruction with a pedicled tensor fasciae lata flap.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4539060&req=5

fig2: Immediate postoperative result following gluteal reconstruction with a pedicled tensor fasciae lata flap.

Mentions: A 52-year-old male and active smoker presented with progressive right gluteal swelling and discomfort for several months. An ultrasound study was performed that demonstrated a fluid collection, aspiration of which showed atypical cells suspicious for malignancy. Subsequent core biopsy revealed high-grade pleomorphic undifferentiated sarcoma. After multidisciplinary evaluation, the plan for this patient was neoadjuvant chemotherapy and radiation therapy, followed by surgical resection and reconstruction. The patient proceeded to receive doxorubicin, ifosfamide, and 50 Gy of external beam radiation therapy. Approximately 8 weeks later, the patient underwent tumor extirpation, which involved resection of skin, subcutaneous tissue, and gluteal musculature, resulting in a 15 × 15 cm defect (Figure 1). The defect was dressed with a negative pressure wound therapy dressing while awaiting final pathologic margins, which were ultimately negative. Due to prior radiation therapy, local tissues were deemed unsuitable for reconstruction, and local recipient vessels for microvascular free tissue transfer were of poor quality and of insufficient length due to the prior resection. Due to these factors and the patient's history of active tobacco use, a pedicled TFL flap was performed (Figure 2). The donor site was closed primarily. The patient was ambulatory without assistance and was discharged by postoperative day 3 and healed without complication after a follow-up of 2.5 months.


Reconstruction of Radiated Gluteal Defects following Sarcoma Resection with Pedicled Sensate Tensor Fascia Lata Flaps.

Chao AH, Kearns PN - Case Rep Oncol Med (2015)

Immediate postoperative result following gluteal reconstruction with a pedicled tensor fasciae lata flap.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4539060&req=5

fig2: Immediate postoperative result following gluteal reconstruction with a pedicled tensor fasciae lata flap.
Mentions: A 52-year-old male and active smoker presented with progressive right gluteal swelling and discomfort for several months. An ultrasound study was performed that demonstrated a fluid collection, aspiration of which showed atypical cells suspicious for malignancy. Subsequent core biopsy revealed high-grade pleomorphic undifferentiated sarcoma. After multidisciplinary evaluation, the plan for this patient was neoadjuvant chemotherapy and radiation therapy, followed by surgical resection and reconstruction. The patient proceeded to receive doxorubicin, ifosfamide, and 50 Gy of external beam radiation therapy. Approximately 8 weeks later, the patient underwent tumor extirpation, which involved resection of skin, subcutaneous tissue, and gluteal musculature, resulting in a 15 × 15 cm defect (Figure 1). The defect was dressed with a negative pressure wound therapy dressing while awaiting final pathologic margins, which were ultimately negative. Due to prior radiation therapy, local tissues were deemed unsuitable for reconstruction, and local recipient vessels for microvascular free tissue transfer were of poor quality and of insufficient length due to the prior resection. Due to these factors and the patient's history of active tobacco use, a pedicled TFL flap was performed (Figure 2). The donor site was closed primarily. The patient was ambulatory without assistance and was discharged by postoperative day 3 and healed without complication after a follow-up of 2.5 months.

Bottom Line: Sarcomas of the gluteal region often result in sizable defects following resection that are challenging to reconstruct due to their location, particularly in patients who have received radiation therapy.A pedicled tensor fascia lata (TFL) flap was therefore performed in both cases, which resulted in durable sensate reconstruction with good functional outcomes and no complications.We believe the pedicled TFL flap represents an important option for the reconstruction of oncologic gluteal defects that provides well-vascularized and sensate tissue from outside the zone of radiation without the need for microsurgical techniques.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, The Ohio State University, Columbus, OH 43212, USA.

ABSTRACT
Sarcomas of the gluteal region often result in sizable defects following resection that are challenging to reconstruct due to their location, particularly in patients who have received radiation therapy. Reconstruction of these defects has been seldom discussed in the literature. We present two patients with large radiated gluteal defects following sarcoma resection, of which one patient received neoadjuvant radiation and the other received intraoperative radiation therapy. As a result of the resection and radiation, local tissues and recipient vessels were unsuitable for use in reconstruction. A pedicled tensor fascia lata (TFL) flap was therefore performed in both cases, which resulted in durable sensate reconstruction with good functional outcomes and no complications. We believe the pedicled TFL flap represents an important option for the reconstruction of oncologic gluteal defects that provides well-vascularized and sensate tissue from outside the zone of radiation without the need for microsurgical techniques.

No MeSH data available.


Related in: MedlinePlus