[Palliative plastic surgery in multidisciplinary therapeutic concepts].

Area of Science:

• Oncology
• Plastic Surgery
• Palliative Care

Context:

• Advanced cancer often presents with painful, exulcerated, or bleeding wounds, significantly impacting patient quality of life.
• While adjuvant and neoadjuvant therapies have improved survival rates, palliative care must address symptom management and quality of life.
• Plastic and reconstructive surgery is increasingly recognized as a viable option for managing complex wounds in palliative cancer patients.

Purpose:

• To review the role and efficacy of plastic and reconstructive surgery in the palliative treatment of advanced cancer-related wounds.
• To discuss conservative and operative treatment options, highlighting evidence from literature and case series.
• To assess the impact of reconstructive procedures on the quality of life for palliative patients.

Summary:

• Literature analysis indicates that reconstructive procedures in palliative settings improve quality of life.
• Plastic surgery interventions are most relevant after conservative wound care failure, particularly for soft tissue sarcomas, squamous cell carcinomas, and breast cancer.
• Procedures range from simple flaps to free flaps and thoracic wall resection, with limb amputation reserved for select cases. Radiation therapy can often be continued post-reconstruction.

Impact:

• Plastic surgery offers significant opportunities to enhance the quality of life for palliative patients with challenging wounds.
• Integration of plastic and reconstructive surgery into multimodal palliative care concepts is crucial.
• Continuous presentation of these procedures in tumor boards can clarify their importance for palliative patient management.