The use of lower abdominal perforator flaps in soft-tissue reconstruction after sarcoma resection.

Abstract

Historically, conventional musculocutaneous flaps have been commonly used for reconstruction after soft tissue sarcoma resection, and the use of lower abdominal perforator flaps has not been popular. This report examined the current role of lower abdominal perforator flaps in sarcoma treatment. We reviewed the outcomes of 14 patients (mean age: 46.3 years, range: 18-79 years) who underwent immediate reconstruction with a deep inferior epigastric artery perforator (DIEP) flap or a superficial inferior epigastric artery (SIEA) flap after sarcoma resection. The defects ranged in size from 7 × 6 cm² to 25 × 22 cm² (mean: 16.5 × 12.1 cm² ). An oblique design was used for pedicled DIEP flaps and a transverse design for free DIEP flaps. Free SIEA flaps were used in six patients, pedicled DIEP flaps in five, and free DIEP flaps in three. The flaps ranged in size from 13 × 8 cm² to 36 × 12.5 cm² (mean: 23.1 × 9.2 cm² ). All DIEP flaps except one were harvested based on one dominant perforator. All flaps survived without vascular compromise. Surgical site infection and seroma occurred at the recipient site in one patient each. No donor-site complications occurred. Lower abdominal perforator flaps can serve as a versatile donor site for reconstruction after sarcoma resection.