title: Reconstruction modality based on the spare part concept for massive soft tissue defects following oncological hemipelvectomy.
abstract: BACKGROUND
  Hemipelvectomy for massive malignancy can result in large soft tissue defects that cannot be reconstructed using conventional posterior flaps. For such cases, reconstruction methods, including a latissimus dorsi flap or a rectus abdominis myocutaneous flap, may be applied, resulting in donor site morbidity. Recent innovations in plastic surgery have resulted in the development of novel reconstruction modalities based on "the spare part concept," applying tissues from amputated limbs.
  
  
  METHODS
  Five subjects with pelvic malignant tumors underwent hemipelvectomy with reconstruction using the spare part concept. Femoral artery-based myocutaneous flap and free fillet lower leg flap were used for three and two cases, respectively. The clinical results, including postoperative complications and oncological outcomes, were assessed.
  
  
  RESULTS
  The mean follow-up period was 43.2 months (range 12-94 months). No local recurrence was encountered in any cases throughout follow-up. As of the final follow-up, three patients remained alive and two patients were dead due to distant metastasis. Minor postoperative infection was observed in two cases.
  
  
  CONCLUSIONS
  The femoral artery-based myocutaneous flap and the free fillet lower leg flap are both useful, safe options for reconstruction of the large defect following extensive hemipelvectomy for malignant bone and soft tissue tumors. The present data support the continued application of these flap reconstruction techniques based on the spare part concept.
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morii
authors.forename: Michiro
authors.initials: M
authors.lastname: Susa
authors.forename: Robert
authors.initials: R
authors.lastname: Nakayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi
authors.forename: Hideo
authors.initials: H
authors.lastname: Morioka
authors.forename: Hiroo
authors.initials: H
authors.lastname: Yabe