Supercharged gracilis myocutaneous flap in reconstruction of the surgical defect after resection of soft tissue sarcoma in extremities: a report of 6 cases
10.3760/cma.j.cn441206-20250109-00010
- VernacularTitle:增压股薄肌肌皮瓣修复重建四肢软组织肉瘤切除后创面6例
- Author:
Huhu WANG
1
;
Zhuo WU
;
Li HAN
;
Meng XU
;
Jianwen ZHAO
Author Information
1. 西安交通大学第一附属医院榆林医院骨科，榆林 719000
- Publication Type:Journal Article
- Keywords:
Soft tissue sarcoma;
Supercharged gracilis myocutaneous flap;
Extremity;
Reconstruction
- From:
Chinese Journal of Microsurgery
2025;48(3):315-320
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of the supercharged gracilis myocutaneous flap in reconstruction of the surgical defects following resection of soft tissue sarcoma (STS) in extremities.Methods:A retrospective analysis was conducted on 6 patients who received surgery to remove STS in extremities followed by reconstructive surgery with a supercharged gracilis myocutaneous flap to reconstruct the surgical defect (16.0 cm×4.8 cm-25.0 cm×8.0 cm), at the Department of Microsurgery, the 4th Medical Centre, Chinese PLA General Hospital between January 2023 and January 2024. The locations of sarcoma were: 3 in left forearm, 2 in right calf and 1 in left calf. The pathological types of the sarcoma were: 1 of myxoid liposarcoma, 1 of dedifferentiated liposarcoma, 1 of alveolar rhabdomyosarcoma, 1 of low-grade myxofibrosarcoma and 2 of fibrosarcoma. According to the Enneking classification, 2 sarcomas were in stage I and 4 in stage Ⅱa. All patients underwent expanded resection of the sarcoma and followed by reconstruction of the surgical defect with supercharged gracilis myocutaneous flap. The flap size ranged from 18.0 cm×5.2 cm to 27.7 cm×10.2 cm, with the length of the muscle flap at 25.92 cm±5.57 cm and 17.0 cm×2.8 cm×2.7 cm-32.0 cm×6.0 cm×3.5 cm in volume. The surgical defects were filled with muscle flaps, while the wounds were covered by cutaneous flaps. The perforating branches of the deep femoral artery carried by proximal vascular pedicle of the myocutaneous flap were anastomosed end-to-end with the prominent vessels of the recipient site. Where, the perforators of the distal femoral artery of the myocutaneous flap were anastomosed end-to-end with the recipient vessels for external blood perfusion, and the great saphenous vein of the flap was anastomosed end-to-end with the superficial veins of the recipient site. All donor sites were directly sutured. Scheduled postoperative follow-ups at outpatient clinic were conducted to assess the viability of the transferred myocutaneous flap. Limb function was evaluated using the Musculoskeletal Tumour Society-93 (MSTS-93) and the Toronto Extremity Salvage Score (TESS).Results:The postoperative follow-up lasted for 12 to 20 months. All 6 myocutaneous flaps survived without distal necrosis. All patients regained daily activities and functioned well. The MSTS-93 scores achieved 24 to 30 (27.0 ± 2.4) points; while the recovery rate of limb function were 85% to 100% (90.00% ± 7.89%) and the TESS were 85% to 100% (93.65% ± 5.47%). No patients exhibited tumour recurrence over the period of follow-up.Conclusion:The supercharged gracilis myocutaneous flap is a safe and effective myocutaneous flap. It serves as an effective method for soft tissue reconstruction after surgical resection of STS in extremities.
