Selection of myocutaneous flaps for reconstruction following oncologic resection of sarcoma

The use of myocutaneous flaps for reconstruction following sarcoma resection is an important surgical technique. In this study, we discuss the issues surrounding proper selection of myocutaneous flaps following wide resection. A total of 59 patients underwent tumor resection and immediate reconstruction. In 26 patients, the tumor location was in the trunk and reconstructed mainly with pedicled latissimus dorsi and tensor fascia lata flaps. Functional muscle transfers were used for extremity reconstruction in 25 patients. Reinnervation was observed for 23 muscles after a mean period of 5.7 months. At final follow-up, primary wound healing was satisfactory in all surviving patients without severe complications. For sarcoma within the trunk, a pedicle latissimus dorsi flap is most suitable. The tensor fascia lata flap is best indicated for lower buttock or abdominal wall sarcomas. For extremity sarcomas, functional latissimus dorsi or gracilis muscle flaps produce good outcomes for restoration of motor function as well as wound healing.