Spare-Part Technique for Covering Soft Tissue Defects in Sarcoma: Clinical Utility and Review of Literature

Excerpt

Sarcomas of the extremities are relatively infrequent tumors, accounting for 1% of adult malignancies [1]. Multiple histological subtypes, diverse clinical presentation, and variable biological activity depict the spectrum of soft tissue sarcomas (STS) [2]. Surgery remains the mainstay modality of treatment of most subtypes of STS of the extremity [3]. The procedure of choice has evolved from amputation to limb salvage largely due to refinement in surgical techniques and imaging technology advancement [4‐6]. Various prospective randomized studies [7] found no statistically significant differences in survival rates when comparing limb-sparing surgery plus radiotherapy with limb amputation. Achieving adequate resection margins is of paramount importance, although there is a sparsity of standardized guidelines that define ideal margins. The objective is to perform a wide resection with microscopic negative margins; hence, sometimes it is inevitable to resort to amputation of the limb to achieve acceptable margins of resection. This brings the “concept of spare parts” which is defined as reutilizing tissues from unsalvageable limbs to reconstruct large defects or to obtain an optimal proximal stump with the needed length for subsequent prosthetization without exploiting the rest of the body for any fresh resources [8]. …