Practical Strategies in Reconstruction of Soft-Tissue Sarcoma | Journal CME Article-Journal CME Article: Practical Strategies in Reconstruction of Soft-Tissue Sarcoma Article

Journal CME Article: Practical Strategies in Reconstruction of Soft-Tissue Sarcoma Article

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The article discusses the challenges and strategies in reconstructing defects following soft-tissue sarcoma (STS) resection, highlighting the need for a multidisciplinary approach. While sarcomas are rare, representing about 1% of adult cancers, their mesenchymal origin allows them to develop in various tissues, such as muscle, bone, and adipose tissue, leading to diverse clinical manifestations.<br /><br />STS management involves a multidisciplinary team of sarcoma oncologic surgery, radiation, and medical oncology, with reconstructive plastic surgery playing a crucial role. Postoperative care also requires rehabilitation specialists to optimize function and quality of life. The article does not cover bone or viscera-involved sarcomas, underscoring the necessity for tailored multimodal treatment strategies.<br /><br />Soft-tissue sarcomas can develop anywhere in the body but are more prevalent in the extremities. Preoperative evaluation, including imaging and genetic considerations, is crucial for planning surgical resection and reconstruction. Reconstruction goals aim to preserve form and function, using an evidence-based algorithmic approach to minimize complications.<br /><br />Reconstruction after STS resection aligns with the reconstructive ladder—primary closure if feasible, otherwise relying on local or free tissue transfer. Each anatomical area, such as head, neck, trunk, breast, and extremities, presents unique considerations, and reconstructive strategies must be tailored to preserve mobility and function while ensuring optimal cosmetic outcomes.<br /><br />The article emphasizes the importance of addressing lymphedema and phantom limb pain, common sequelae of sarcoma treatment. Techniques like lymphovenous bypass and vascularized lymph node transfer have proven effective in managing lymphedema, while targeted muscle reinnervation is a promising solution for preventing neuroma and phantom limb pain after amputation.<br /><br />Overall, the article is a comprehensive guide on the reconstructive techniques and principles necessary in managing sarcoma-related defects, underscoring the need for individualized patient care through a multidisciplinary and multimodal approach.

Keywords

soft-tissue sarcoma

reconstruction

multidisciplinary approach

oncologic surgery

plastic surgery

rehabilitation

preoperative evaluation

reconstructive ladder

lymphedema management

phantom limb pain