Adductor Myocutaneous Flap Coverage for Hip and Pelvic Disarticulations of Sarcomas with Buttock Contamination

Marfori, Michael L.; Wang, Edward H. M.

doi:10.1007/s11999-010-1467-5

Cited by 14 publications

(14 citation statements)

References 18 publications

(33 reference statements)

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“…To overcome these problems, pedicled or free myocutaneous fl aps have been used for wound closure, and polytetrafl uoroethylene mesh (Gore-Tex) and acellular dermal matrices GraftJacket (Wright Medical Technology, Arlington, Tennessee) are used to repair retroperitoneal defects and prevent hernias. 35,[97][98][99]…”

Section: Wound Closurementioning

confidence: 99%

“…The medial thigh adductor myocutaneous fl ap is an option for hemipelvectomy closure in patients with tumors involving the buttock and anterolateral upper thigh. 99,108 Another option is the axial thigh fi llet fl ap, which is based on the spare parts concept that uses residual tissue from amputated limbs for complex soft tissue reconstructions, thereby limiting donor-site morbidity by not further involving healthy structures. [109][110][111] The free fi llet lower leg fl ap is a free fl ap raised from the calf and is supported by the popliteal artery anastomosed to the cut end of the internal iliac artery in an end-to-end fashion.…”

Section: A 11bmentioning

confidence: 99%

See 1 more Smart Citation

Pelvic Resections

Mavrogenis¹,

Soultanis²,

Patapis³

et al. 2012

Orthopedics

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The complexity of pelvic anatomy and the extent of tumor growth makes treatment of patients with primary bone sarcomas in the pelvis difficult in terms of local control. Before the 1970s, most tumors in the bony pelvis were surgically treated with hindquarter amputation. Currently, improved techniques for clinical staging, adjuvant treatments, evolutions in metallurgy, and development of new surgical techniques make limb-salvage surgery and reconstruction possible alternatives to hemipelvectomy and resection-arthrodesis. The advantages of amputation over resections at the pelvis are a lower incidence of complications, a limited area at risk for recurrence, and a faster recovery time compared with all but the most limited pelvic resections. The disadvantages, especially after periacetabular resections, are leg-length discrepancy and impaired hip and gait function. The indication for limb salvage is the ability to obtain wide margins without compromising survival and function. Although having to resect the sciatic nerve to obtain adequate margins does not always mean that an amputation should be performed, the combination of a major pelvic resection and the functional consequences of sciatic nerve resection results in an extremity usually not worth saving; loss of femoral nerve function does not result in a significant gait disturbance, especially if the hemipelvis is stable. Reconstruction options after major pelvic resections have also evolved, but they remain difficult, especially when the acetabulum is involved.

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Section: Wound Closurementioning

confidence: 99%

Section: A 11bmentioning

confidence: 99%

Pelvic Resections

Mavrogenis¹,

Soultanis²,

Patapis³

et al. 2012

Orthopedics

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show abstract

“…Hence, pedicled or free musculocutaneous flaps have been used to tackle wound compications. 34,36,37,47 The vertical rectus abdominis muscle flap (VRAM) is increasingly becoming more popular in the closure of large sacral defects given its abundant supply of well-vascularized tissue, reliability, and simplicity of dissection.…”

Section: Discussionmentioning

confidence: 99%

A new type of reconstruction of the hemipelvis after Type 3 amputative sacrectomy using pedicled fibula

Starantzis

Sakellariou

Rose

et al. 2014

SPI

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This is a technical note of pelvic reconstruction performed by an advanced multidisciplinary team. The authors report a new 3-stage reconstruction of the hemipelvis after Type 3 sacrectomy involving instrumented spinoiliac arthrodesis and pedicled fibula grafting in 2 patients. The anterior stage of the procedure begins with a transabdominal approach to mobilize the viscera and to free up the tumor from the vessels. The posterior divisions of internal iliac vessels, the middle sacral vessels, and the lateral sacral vessels are then ligated. An anterior vertebrectomy is done at the appropriate level, followed by an anterior osteotomy through the lateral planed surgical margin of the sacrum close to the salvaged sacroiliac joint. The second stage includes a major sacral resection with lower-extremity amputation from the pubic symphysis through the intact side of the sacrum, ipsilateral pedicled fibula harvesting, and closure with an ipsilateral pedicled quadriceps flap. The final stage involves reconstruction with lumboiliac instrumentation. The pedicled fibular graft left from the second stage is then placed distally within the previously created iliopectineal docking site and proximally within the L-5 docking site. The authors believe that this is a feasible and reproducible technique with theoretical advantages that have to be proved in the long-term follow-up.

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“…Кровоснабжение мышечной части трансплантата при таком типе пластики осуществляется через глубокую бедренную артерию и запирательные сосуды, а кожа, клетчатка и фасция кровоснабжаются за счет бедренной и глубокой бедренной артерий [36]. M. Marfori выполнил 4 МПБВ с использованием приводящего лоскута без значимых послеоперационных осложнений [37]. A.…”

Section: альтернативные методики пластикиunclassified

Interiliac-abdominal exarticulation: The history of development and the relevance of use in modern pelvic cancer surgery

Karpenko¹,

Derzhavin²,

Bukharov³

et al. 2017

Onkol. Z. im. P.A. Gercena

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Adductor Myocutaneous Flap Coverage for Hip and Pelvic Disarticulations of Sarcomas with Buttock Contamination

Abstract: Level IV therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Cited by 14 publications

References 18 publications

Pelvic Resections

Pelvic Resections

A new type of reconstruction of the hemipelvis after Type 3 amputative sacrectomy using pedicled fibula

Interiliac-abdominal exarticulation: The history of development and the relevance of use in modern pelvic cancer surgery

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