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Azadgoli et al. Plast Aesthet Res 2018;5:3 Plastic and
DOI: 10.20517/2347-9264.2017.32 Aesthetic Research

Review Open Access

Complex reconstruction of the lower extremity
following sarcoma resection: a literature review

Beina Azadgoli, Antoine L. Carre, David P. Perrault, Alex K. Wong

Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine of USC, Los Angeles, CA 90033, USA.
Correspondence to: Dr. Alex K. Wong, Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine
of USC, 1510 San Pablo Street, Los Angeles, CA 90033, USA. E-mail: Alex.Wong@med.usc.edu
How to cite this article: Azadgoli B, Carre AL, Perrault DP, Wong AK. Complex reconstruction of the lower extremity following sarcoma
resection: a literature review. Plast Aesthet Res 2018;5:3. http://dx.doi.org/10.20517/2347-9264.2017.32

Received: 29 Apr 2017 First Decision: 30 Nov 2017 Revised: 3 Jan 2018 Accepted: 4 Jan 2018 Published: 29 Jan 2018
Science Editor: Raúl González-García Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract

While amputation was traditionally the only option available for patients with sarcomas of the extremities, chemotherapy,
radiation, and advances in microsurgical technique have allowed many patients to undergo limb-salvaging procedures.
Given the low incidence and heterogeneity of these tumors, there is currently no standard treatment algorithm for limb
reconstruction after large sarcoma resection. Thus, we systematically reviewed the various types of free tissue transfer
used for the reconstruction of lower limbs after sarcoma resection. Techniques were described based on anatomic
location. This literature review supports free tissue transfer as a safe and acceptable modality for reconstruction after
sarcoma resection of the lower limb. It allows for the application of healthy vascularized tissue to the defect while also
providing freedom of flap positioning. Flap choice is dependent on tumor and defect size, tissue type and function, as well
as donor site availability.

Keywords: Lower extremity, sarcoma, reconstruction

INTRODUCTION
[1]
Soft tissue and bone sarcomas represent about 1% of all adult tumors , affecting 1.8-5 out of every 100,000
[2]
people annually . The lower limb is the most common site of sarcoma occurrence, representing 29%-40%
[3,4]
of all cases . Although amputation was traditionally the only option available for patients with sarcoma
of the extremities, recent implementation of a multimodal treatment approach along with advancements
in chemotherapy and microsurgical techniques has led to the influx of limb salvage therapy for these
[5,6]
cancers . Currently, wide tumor excision combined with adjuvant and or neo-adjuvant therapy is the
[2]
standard of care for the successful treatment of sarcoma of the lower limbs .

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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