Application research of fasciocutaneous lfaps in repairing large defects after tumor resection around the joints of limbs

YAO Wei-tao; CAI Qi-qing; WANG Jia-qiang; GAO Song-tao; ZHANG Peng; WANG Xin

doi:10.3969/j.issn.2095-252X.2013.11.005

Abstract：Objective To analyze the feasibility and related complications of fasciocutaneous lfaps in the reconstruction of large skin defects after the resection of soft tissue tumors around the joints of limbs. Methods From January 2007 to January 2012, 39 patients with malignant soft tissue tumors around the wrist, elbow, hip, knee, ankle and so on were treated by wide resection of lesions, and fasciocutaneous lfaps in the adjacent areas were transferred to cover the wound in our hospital. There were 21 males and 18 females, with an average age of 45.72 years old ( range;14-73 years ). Among these patients, 10 cases had primary diagnosis, 14 cases had extended resection again in primary sites within 6 months after the operation and 15 cases had tumor relapse postoperatively. The size of skin defects after tumor resection, types of fasciocutaneous lfaps, postoperative healing of the wound and lfaps, appearance and function of the involved joints, tumor relapse and so on were observed and recorded in all patients. Results 5 patients had tumor resection in the wrist joint, 3 in the elbow joint, 8 in the hip joint, 6 in the knee joint and 17 in the ankle joint. The adapted lfaps included radial wrist upper branch fasciocutaneous lfap in 5 cases, lateral upper arm fasciocutaneous lfap in 3, inguinal fasciocutaneous lfap in 3, broad tensor fasciocutaneous lfap in 3, thigh rear fasciocutaneous lfap in 2, crus rear fasciocutaneous lfap in 6 and sura nervous retrograde fasciocutaneous lfap in 17. All the defects were covered by fasciocutaneous lfaps perfectly, with sufifcient blood supply. All the fasciocutaneous lfaps survived normally, except that 2 patients had light edge necrosis and 1 had superifcial infections. The lfaps were accepted by all patients due to their good appearance. The involved joints had normal range of motion ( ROM ) and excellent musculoskeletal tumor society score ( MSTS ) and Toronto extremity salvage score ( TESS ). No complications such as extensive lfap necrosis, serious contraction of lfaps after the operation and so on were found in the patients. Signiifcant differences existed in the recurring rate among the primary diagnosis, extended resection and relapse groups. Conclusions Fasciocutaneous lfaps have the advantages such as sufifcient blood supply, large area of coverage, good elastic, moderate thickness, low necrosis and infection rate of lfaps postoperatively and so on, which are suitable for repairing large defects after the resection of soft tissue tumors around the joints.