Lim Ming Chin, Halim Ahmad Sukari
Plastic and Reconstructive Surgery trainee, Reconstructive Sciences Department, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia.
Plastic and Reconstructive Surgeon, Reconstructive Sciences Department, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia.
J Plast Reconstr Aesthet Surg. 2025 May;104:139-145. doi: 10.1016/j.bjps.2025.02.034. Epub 2025 Feb 22.
Various aspects of dermatofibrosarcoma protuberans (DFSP) management have been explored, including clinical presentation, recommended resection margins, and the role of adjuvant therapy. Multiple reconstruction methods have also been introduced to restore function and aesthetics following DFSP excision.
A retrospective study on reconstruction methods and outcomes for a series of patients with DFSP post-resection was conducted in the Plastic and Reconstructive Unit, Hospital Universiti Sains Malaysia, Kelantan, from 2013 to 2023.
A total of 7 patients were identified during this retrospective study, which consisted of 3 female and 4 male patients. Six patients with head and neck lesions post-excision with a median margin of 3.5 cm underwent immediate soft tissue reconstruction with a free flap (either the anterolateral thigh or latissimus dorsi), and 1 patient with a lesion over the upper extremities underwent immediate soft tissue reconstruction with a pedicled flap following wide resection of the lesion. Only 1 developed a flap-related complication. The overall functional and cosmetic assessments of the reconstructed part were good. Four patients underwent adjuvant radiation therapy, and none of the patients developed local recurrence during follow-up.
Post-resection soft tissue reconstruction of huge defects with free flaps has shown good functional and aesthetic outcomes.
已对隆突性皮肤纤维肉瘤(DFSP)治疗的各个方面进行了探索,包括临床表现、推荐的切除边缘以及辅助治疗的作用。还引入了多种重建方法,以在DFSP切除后恢复功能和美观。
2013年至2023年,在马来西亚吉兰丹州马来西亚理科大学医院整形与重建科,对一系列DFSP切除术后患者的重建方法和结果进行了回顾性研究。
在这项回顾性研究中,共确定了7例患者,其中包括3例女性和4例男性患者。6例头颈部病变切除术后切缘中位数为3.5 cm的患者,采用游离皮瓣(股前外侧皮瓣或背阔肌皮瓣)进行了即刻软组织重建,1例上肢病变患者在病变广泛切除后采用带蒂皮瓣进行了即刻软组织重建。仅1例发生了与皮瓣相关的并发症。重建部位的整体功能和美容评估良好。4例患者接受了辅助放疗,随访期间无患者出现局部复发。
采用游离皮瓣对巨大缺损进行切除后软组织重建,已显示出良好的功能和美学效果。