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2022, Number 2

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Cir Plast 2022; 32 (2)

Random pattern local flap for coverage of upper extremity soft tissue liposarcoma resection

Barajas-Puga JÁ, Lira-Álvarez EA, López-Giacoman C, Sánchez-Martínez MA

Language: Spanish
References: 26
Page: 104-108
PDF size: 342.15 Kb.


ABSTRACT

Soft tissue sarcomas are rare forms of cancer, about 15% of sarcomas grow in the upper extremities and of these, liposarcoma has been linked to p53 and MDM2 gene mutations. Treatment strategies are based on wide surgical excision with a focus on limb salvage, reserving amputation for advanced cases. Reconstruction of defects of the upper extremity is a challenging task for a plastic surgeon. Random pattern local flaps are reconstructive options. The perforator flap of the thoracodorsal and thoracolateral arteries contain skin without muscle and it is based on their perforators; it is used in defects of the trunk, axilla, proximal arm and locoregional reconstruction without injuring any muscle. We present the case of a 47-year-old man with a 14 x 10 cm tumor lesion in his left arm, who underwent oncological resection and reconstruction with a local fasciocutaneous random pattern flap, dependent on artery perforators of the thoracodorsal and thoracolateral artery owing to a histological diagnosis of liposarcoma. The postoperative evolution was satisfactory, no recurrence was observed during the follow-up period and the axillar range of motion returned to normal. We concluded that reconstructive surgery of the upper limb is very challenging due to the poor viability of local tissues. The local random pattern, perforator-based flap of thoracodorsal and thoracolateral arteries is versatile, useful for soft tissue sarcomas of the upper extremity. A multidisciplinary teamwork is possible to save the limb. The local random pattern flap can be an option and a weapon in the reconstructive arsenal.


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