Wound coverage after modified hip disarticulation using a total adductor myocutaneous flap.

There are several options available for wound coverage after hip disarticulation and hemipelvectomy. Standard flaps for closure are not always available due to the 3-dimensional extent of the tumor and availability of satisfactory tissue for coverage. This article details a new coverage technique after a modified hip disarticulation using a total adductor myocutaneous flap in a patient with radiation induced osteosarcoma of the femur after Ewing's sarcoma. In this case, neither the commonly used posterior flap nor an anterior flap could be used because of the location of the tumor and the presence of radiation induced skin and soft tissue changes. The total adductor myocutaneous flap allowed for wide surgical margins, avoided soft tissue coverage using previously irradiated soft tissue flaps, and provided excellent coverage without requiring the use of free or pedicle based flaps.