Marginal Skin Flap Advancement: A Technique to Optimize the Skin Graft Interface Following Tumor Resections

Area of Science:

• Surgical Oncology
• Reconstructive Surgery
• Dermatology

Background:

• Soft tissue defects are common after sarcoma resections.
• A step-off with subcutaneous adipose tissue often complicates defect closure.
• Split-thickness skin grafting (STSG) is a frequent reconstructive method.

Purpose of the Study:

• To evaluate the success of marginal skin flap advancement for soft tissue defects.
• To assess the impact of this technique on STSG outcomes.
• To determine complication rates and need for secondary operations.

Main Methods:

• Retrospective review of 71 cases undergoing sarcoma resection and marginal skin flap advancement.
• Analysis of defect size reduction, STSG take rate, and wound healing complications.
• Inclusion of cases treated with vacuum-assisted closure therapy.

Main Results:

• Marginal skin flap advancement reduced defect size by 41% (217 to 128 cm²).
• STSG was successful in 97% of cases with a 96% mean graft take.
• 41% experienced wound healing complications, but only 15% required reoperation.

Conclusions:

• Marginal skin flap advancement is a successful surgical technique for soft tissue defects post-sarcoma resection.
• This method significantly decreases the surface area requiring STSG.
• Combined with vacuum-assisted closure, it offers an excellent reconstructive option.