Considerations surrounding reconstruction after resection of musculoskeletal sarcomas

The defects left by resection of bone and soft-tissue sarcomas often require reconstructive surgery to provide adequate wound coverage, preserve limb function, and optimize cosmetic results. Immediate reconstruction should always be considered after resection with a negative margin, and should be attempted whenever possible. The choice of reconstructive method and tissue flap depends on multiple factors, including body site, donor site morbidity, functional requirements, size of the vascular pedicle, and aesthetics. Preoperative planning before the resection should anticipate the defect size and resulting functional and cosmetic deficits; the success of such planning depends on a collaborative approach between the teams performing the primary resection and the reconstruction. Vigilant postoperative care and flap monitoring is key to avoiding flap or graft failure, hematoma, infection, and other reconstruction-related complications.