Perforator versus traditional flaps in extremity soft-tissue sarcoma reconstruction: A comparative cohort study

Area of Science:

• Plastic Surgery
• Surgical Oncology
• Orthopedic Oncology

Background:

• Limb-sparing surgery for extremity soft-tissue sarcoma (eSTS) often results in complex defects requiring reconstruction.
• The reliability of perforator flaps for eSTS reconstruction is debated compared to traditional flaps.

Purpose of the Study:

• To directly compare the outcomes of perforator flaps versus traditional flaps in the reconstruction of defects following eSTS resection.

Main Methods:

• Retrospective cohort study of 156 patients undergoing eSTS excision and flap reconstruction (2016-2021).
• Patients were divided into perforator flap and traditional flap groups.
• Outcomes assessed included operative time, complications, wound care duration, reoperation, readmission, and amputation rates.

Main Results:

• Perforator flaps were more commonly used for distal tumors and recurrent eSTS.
• Operative time and overall complication rates were similar between perforator and traditional flaps.
• While free perforator flaps showed shorter initial hospital stays, this was not significant in multivariable analysis.

Conclusions:

• Perforator flaps provide oncologically safe and functionally reliable reconstruction for eSTS.
• Complication rates are comparable to traditional flaps, supporting their use in eSTS reconstruction.