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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Li Bin,Yang Yong,Li Pengcheng,et al.Clinical efficacy of thinned free flaps for wound reconstruction after extremity malignant tumor resection[J].Chin J Burns Wounds,2026,42(8):1-9.DOI: 10.3760/cma.j.cn501225-20260426-00167.
Citation: Li Bin,Yang Yong,Li Pengcheng,et al.Clinical efficacy of thinned free flaps for wound reconstruction after extremity malignant tumor resection[J].Chin J Burns Wounds,2026,42(8):1-9.DOI: 10.3760/cma.j.cn501225-20260426-00167.
shu

Clinical efficacy of thinned free flaps for wound reconstruction after extremity malignant tumor resection

doi: 10.3760/cma.j.cn501225-20260426-00167
  • 1.

    Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China

  • 2.

    Department of Orthopedic Oncology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China

Funds:

Beijing Hospitals Authority's Ascent Plan DFL20240402

Beijing Municipal Health System's High-Level Health Professional Training Program 2015-3-036

More Information
  • Corresponding author: Yang Yong, Email: 0414yang@sina.com
  • Received Date: 2026-04-26
    Available Online: 2026-08-03
    Abstract
  •   Objective  To evaluate the clinical efficacy of thinned free flaps in repairing soft tissue defects following resection of extremity malignant tumors.  Methods  This study was a retrospective case series study. From June 2023 to February 2026, 17 patients with extremity malignant tumors who met the inclusion criteria were admitted to the Department of Hand Surgery, Beijing Jishuitan Hospital of Capital Medical University. The cohort consisted of 11 males and 6 females, aged 38-91 years. Tumors were located in the upper extremity in 9 cases and in the lower extremityin 8 cases. Pathological diagnoses included squamous cell carcinoma (6 cases), dermatofibrosarcoma protuberans (2 cases), liposarcoma (2 cases), synovial sarcoma (2 cases), malignant peripheral nerve sheath tumor (2 cases), epithelioid sarcoma (1 case), and angiosarcoma (2 cases). All patients underwent wide tumor resection, resulting in soft tissue defects with exposure of deep structures. The defect size ranged from 4 cm×4 cm to 24 cm×12 cm. Thinned free flaps were used for wound repair, including anterolateral thigh flaps (7 cases), groin flaps (6 cases), medial sural artery perforator flaps (2 cases), deep inferior epigastric artery perforator flaps (1 case), and medial plantar flaps (1 case). The flap size ranged from 4 cm×4 cm to 24 cm×13 cm, with a thickness of 4-10 mm (with mean of 5.8 mm). Donor sites were closed by direct suture and local relay flap or skin grafting. Postoperative flap survival and recipient site complications (infection, hematoma, delayed wound healing, etc.) were recorded, along with donor site healing status and associated complications. A comprehensive assessment of reconstructive outcomes (excellent, good, and poor) was conducted at the final follow-up. Tumor prognosis of all patients was tracked and documented.  Results  Sixteen flaps survived completely with ruddy color, normal skin temperature, and intact capillary refill. One patient who underwent groin flap reconstruction for a defect following resection of angiosarcoma on the dorsum of the hand developed epidermal necrosis at the distal portion of the flap on postoperative day 3, which healed after routine dressing changes. No infection, hematoma, or delayed wound healing occurred in any recipient site. Donor sites healed uneventfully in 15 patients, while 2 patients experienced delayed healing. No major complications were observed in any donor site. At the last follow-up, the reconstructive outcomes were rated as excellent in 14 patients and good in 3 patients. The follow-up period ranged from 2 to 34 months. Local recurrence occurred in 3 patients at 24, 10, and 3 months postoperatively, respectively. Metastasis (lymph node and distant) occurred in 2 patients at 11 months postoperatively in both cases. The remaining 12 patients showed no evidence of local recurrence or distant metastasis.  Conclusions  Thinned free flaps are effective for reconstructing wounds following extremity malignant tumor resection, with a high flap survival rate, satisfactory reconstructive outcomes, and low donor-site morbidity.

     

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