Isao Koshima1*, Shuhei Yoshida1, Shogo Nagamatsu2, Kazunori Yokota2, Shuji Yamashita3, Haruki Mizuta4 and Dalia Tobbia5
1International Center for Lymphedema, Hiroshima University, Japan 2Department of Plastic and Reconstructive Surgery, Hiroshima University, Japan 3Department of Plastic and Reconstructive Surgery, The University of Tokyo, Japan 4Department of Plastic and Reconstructive Surgery, National Cancer Center (former Okayama University Medical School, Okayama), Japan 5Department of Plastic and Reconstructive surgery, Plastische Chirurgie am Klosterstern, GermanyFulltext PDF
A case with recurrent liposarcoma is described in where combined VRAMC flap and emergency free latissimus dorsi musculocutaneous flap as well as artificial hip joint-femur, and femoral vessels were successfully transferred for repair of massive anterior thigh defect. The concept of a hybrid combination with tissue transfers including biomaterials (bone and vessels) can preserve a limb with widely invasive recurrent sarcoma. Emergency free LDMC flap transfer with flow-through pedicle anastomosis is also important to prevent exposure of artificial vessels and bone. In addition, prophylactic LVA is also very important approach for the prevention of postoperative lymphedema as a serious complication after massive resection in the proximal thigh.
Koshima I, Yoshida S, Nagamatsu S, Yokota K, Yamashita S, Mizuta H, et al. Hybrid Combined Flaps and Biomaterials for Preservation of Ischemic Limb Following Massive Ablation of Recurrent Sarcoma. Clin Surg. 2019; 4: 2639..