title: Forequarter amputation with fasciocutaneous deltoid flap reconstruction for malignant tumors of the upper extremity.
abstract: BACKGROUND
  Malignant tumors of the upper extremity involving a considerable portion of the medial axillary wall may require forequarter amputation to achieve gross resection of tumor. These resections frequently leave a large defect, often requiring a split thickness skin graft or free flap to close the wound. To address this problem of wound closure, we have modified our technique and devised a reconstructive component as part of our forequarter amputation procedure.
  
  
  METHODS
  The medical records of seven patients who underwent forequarter amputation and fasciocutaneous deltoid flap reconstruction between 1982 and 1994 were reviewed.
  
  
  RESULTS
  All the amputation sites were completely closed with a fasciocutaneous deltoid flap without the use of additional skin grafts or free flaps. After a median follow-up of 12 months, there were no local recurrences. Three patients (43%) are alive and disease free 5, 12, and 19 months after their forequarter amputation. One patient is alive with disease after 14 months. The remaining three patients died of their disease.
  
  
  CONCLUSIONS
  The fasciocutaneous deltoid flap is technically easy to perform, provides wound coverage without the use of skin grafts, and is especially useful for tumors involving the media axillary wall and in patients with previous axillary radiation.
authors.affiliation: Department of Surgery, State University of New York at Buffalo, School of Medicine, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Volpe
authors.forename: S
authors.initials: S
authors.lastname: Peterson
authors.forename: R J
authors.initials: RJ
authors.lastname: Doerr
authors.forename: C P
authors.initials: CP
authors.lastname: Karakousis
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001132:Arm / Q000601:surgery*; D001365:Axilla; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D018219:Histiocytoma, Benign Fibrous / Q000601:surgery; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013524:Surgical Flaps