Reconstruction for limb-sparing procedures in soft-tissue sarcomas of the extremities.

An understanding of the biology of soft-tissue sarcomas and knowledge of refined techniques of adjuvant therapy have allowed limb-sparing procedures to become predominant in the management of these tumors. Immediate bony reconstruction with prosthetic implantation has met with consistent success largely because of the vascularized coverage provided by local and distant flaps. Microvascular reconstruction allows wound closure with vascularized tissue in one stage. The use of a distant donor site does not alter the function of an already compromised limb as would a local muscle flap, and, in selected cases, the transplant may augment the functional ability of the limb. The use of a distant site also does not require extensive dissection in regional tissue planes, which theoretically could spread the local disease.