Reconstruction of soft-tissue defects at the foot and ankle after oncological resection

  • \(\textbf {Introduction:}\) Solid malignancies at the foot and ankle region are rare and include mainly soft-tissue sarcomas, bone sarcomas, and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical techniques can frequently reduce functional impairment and cover soft-tissue defects, particularly in cases of large tumor size or localization adjacent to critical anatomic structures, thereby improving the quality of life for these patients. The aim of this article is to illustrate the various treatment options of plastic surgery in the multimodal therapy of patients with malignant tumors of the foot and ankle region. \(\textbf {Materials and methods:}\) This article is based on the review of the current literature and the evaluation of the author’s own patient database. \(\textbf {Results:}\) The local treatment of malignant extremity tumors has undergone major changes over the last few decades. Primary amputations have been increasingly replaced by limb-sparing techniques, preserving extremity function as much as possible. Although defect coverage at the foot and ankle region is demanding due to complex anatomical features and functional requirements, several plastic surgical treatment options can be implemented in the curative treatment of patients with malignant solid tumors in this area. Soft-tissue defects after tumor resection can be covered by a variety of local flaps. If local flaps are not applicable, free flap transfer, such as the anterolateral thigh flap, parascapular flap, or latissimus dorsi flap, can be utilized to cover nearly all kinds of defects in the foot and ankle region. \(\textbf {Conclusion:}\) Soft-tissue reconstruction in the foot and ankle region is a vital component of limb-sparing surgery. It enables complete resection of locally advanced tumors and subsequent adjuvant radiotherapy. Modern plastic surgical techniques should, therefore, be integrated in the multimodal treatment concept of malignancies in the foot and ankle region.

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Metadaten
Author:Andrej RingGND, Pascal KirchhoffGND, Ole GoertzGND, Björn BehrORCiDGND, Adrien DaigelerORCiDGND, Marcus LehnhardtGND, Kamran HaratiGND
URN:urn:nbn:de:hbz:294-57944
DOI:https://doi.org/10.3389/fsurg.2016.00015
Parent Title (English):Frontiers in surgery
Document Type:Article
Language:English
Date of Publication (online):2018/06/28
Date of first Publication:2016/03/08
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
flap; lower extremity; microsurgery; reconstructive surgical procedures; sarcoma
Volume:3
First Page:15-1
Last Page:15-9
Note:
Article Processing Charge funded by the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgie-Zentrum
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
faculties:Medizinische Fakultät
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International