Free Fibula Flap for Extremity Oncologic Defects: Factors Influencing Union and Functional Outcomes.

Background: The goal of this study was to evaluate outcomes after vascularized bone flap (VBF) reconstruction of oncologic bony extremity defects. A secondary goal was to compare union rates based on various insetting methods, including onlay, intermedullary, and intercalary.

Methods: The authors conducted a retrospective review of consecutive patients who received an extremity reconstruction with a fibula flap after oncologic resection between 2001 and 2019.

Robotic Rectus Abdominis Muscle Flap following Robotic Extirpative Surgery.

Summary: Vascularized tissue for obliteration of large pelvic dead spaces created by extirpative surgery has been shown to reduce complication rates. As more extensive resections are performed robotically, plastic surgeons have been challenged to reconstruct the resulting defects using a minimally invasive approach. The goal of this study was to report the authors' experience with robotic harvest of the rectus abdominis muscle for reconstruction of pelvic defects.

Postpartum Treatment of Metastatic Recurrent Giant Cell Tumor of Capitate Bone of Wrist.

Giant cell tumors (GCTs) are aggressive benign lesions that occur in the bone epiphysis. They are most often found in the long bones of the lower extremities. Wrist bone involvement is rare, capitate bone involvement exceedingly rare.

Operative and Oncologic Outcomes in 9861 Patients with Operable Breast Cancer: Single-Institution Analysis of Breast Conservation with Oncoplastic Reconstruction.

Background: Oncoplastic reconstruction is an approach that enables patients with locally advanced or adversely located tumors to undergo breast conserving surgery (BCS). The objectives were to identify the use of BCS with oncoplastic reconstruction (BCS + R) and determine the operative and oncologic outcomes compared with other breast surgical procedures for breast cancer.

Methods: This retrospective cohort study interrogated a single institution's prospectively maintained databases to identify patients who underwent surgery for breast cancer between 2007 and 2014.

Autoderm: an alternative bioprosthetic for breast reconstruction.

The widespread use of bioprosthetic mesh in breast reconstruction has revealed an increased risk of seroma and infection, and a high financial cost. This study introduces a technique that mitigates these shortcomings using an autologous dermal graft (Autoderm). Indications, operative technique, and 1-year outcomes are reviewed.

Composite extremity and trunk reconstruction with vascularized fibula flap in postoncologic bone defects: a 10-year experience.

Background: Obtaining good functional outcomes with reconstruction following resection of primary bone tumors of the trunk and extremities is a significant challenge. The authors present their reconstructive experience using vascularized fibula flap transfer to improve bone healing and optimize functional outcomes.

Methods: From 2001 to 2010, 52 consecutive patients received 53 fibula flaps for trunk (n = 19), lower extremity (n = 21), and upper extremity (n = 13) composite reconstructions.

Allograft-prosthetic composite reconstruction of the proximal part of the tibia. An analysis of the early results.

Background: Allograft-prosthetic composite reconstruction of the proximal part of the tibia is one option following resection of a skeletal tumor. Previous studies with use of this technique have found a high prevalence of complications, including fracture, infection, extensor mechanism insufficiency, and loosening. To address some of these problems, we adopted certain measures, including muscle flap coverage, meticulous tendon reconstruction, rigid implant fixation, and careful rehabilitation.

Reconstruction of the pelvic ring with vascularized double-strut fibular flap following internal hemipelvectomy.

Background: After internal hemipelvectomy, successful pelvic reconstruction can provide a durable and pain-free reconstruction for the young, active patient. Such reconstruction is extremely challenging, and often patients have less than optimal ambulation with a limp, leg length discrepancy, or leg instability. The authors present an innovative method for pelvic ring reconstruction using a vascularized double-strut fibular bone flap that provides a stable pelvis and recovery of normal or near-normal gait.

Staged reconstruction for resection wounds in sarcoma patients treated with brachytherapy.

Adjuvant brachytherapy reduces local recurrences following wide local excision of large, high-grade sarcomas, but its use with immediate flap reconstruction is associated with a high wound complication rate following previous radiotherapy. To avoid flap irradiation and reduce wound-healing morbidity, a treatment strategy using negative-pressure wound therapy (NPWT) for temporary wound coverage during brachytherapy followed by delayed flap reconstruction was used in 3 previously irradiated sarcoma patients. NPWT was continued after brachytherapy catheter removal to stimulate vascularization, granulation, and wound contraction.