Drake D B
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, USA.
Clin Plast Surg. 1995 Jan;22(1):123-8.
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.
对软组织肉瘤生物学的理解以及辅助治疗精细技术的知识，使得保肢手术在这些肿瘤的治疗中占据主导地位。即刻进行假体植入的骨重建取得了持续的成功，这很大程度上归功于局部和远处皮瓣提供的血管化覆盖。微血管重建可在一期用血管化组织闭合伤口。使用远处供区不会像局部肌皮瓣那样改变已受损肢体的功能，而且在某些情况下，移植可能增强肢体的功能能力。使用远处供区也不需要在区域组织平面进行广泛的解剖，从理论上讲，这可能会扩散局部疾病。
