<< Back to the abstract archive
Spare parts reconstruction of complex external hemipelvectomy defects
Nabil Habash MD, James Boehmler MD, Joel Mayerson MD, Michael Miller MD
Ohio State University
2010-03-19
Presenter: Nabil Habash MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: External hemipelvectomies are most frequently performed for cure or palliation of soft tissue or bony malignancies involving the pelvis or proximal thigh. There have been advances in skin flap survival based on designing posteriorly or anteriorly based flaps that incorporate gluteal or quadricep muscles, respectively. There are tumors, based on location, size, or patient factors, which preclude the use of standard flap design techniques for closure.
Methods: Retrospective review of three patients who underwent external hemipelvectomy and staged reconstruction with free or pedicled spare part flaps from the amputated extremity. Reasons for not using standard flap techniques were prior radiation therapy and extensive hip surgery, need for bony stabilization of the sacrum and pelvic ring, and tumor location and size. Reconstruction involved two free fillet leg flaps and one pedicled flap utilizing the femur, fibula, and quadriceps musculocutaneous flap. All three resections and reconstructions were staged over 2 days.
Results: All patients were discharged from the hospital, average length of stay was 32 days (Range 17-47 days). There were two complications: one patient had a DVT, and one patient had a wound dehiscence requiring reoperation and drain placement. Mean follow-up is 8 months, two patients are alive and disease free at last follow-up, one patient died of metastatic disease at 6 months after resection.
Conclusion: Spare parts reconstruction of complex external hemipelvectomy defects requires careful planning between surgical subspecialties. Overall complication rates are acceptable, wound healing was achieved in all patients, and donor site morbidity is avoided.
