title: Abdominoplasty and thoraco-epigastric flaps for large anterior trunk defects after dermatofibrosarcoma protuberans wide resection: Two illustrative cases.
abstract: BACKGROUND
  Excision of large dermatofibrosarcoma protuberans in the anterior aspect of the trunk often results in large surgical defects that frequently dictate the need for microsurgical reconstruction. However, this option is not always available.
  
  
  METHODS
  The authors describe two patients with very large anterior trunk dermatofibrosarcoma protuberans: one in the epigastric region and the other in the hypogastric region. In the patient with the hypogastric tumor, a classical abdominoplasty flap associated with umbilical transposition was used to cover the skin defect after muscle and fascial plication, and placement of a polypropylene mesh. In the patient with the epigastric tumor, a synthetic mesh was also placed, and the skin and subcutaneous defect was reconstructed with a reverse abdominoplasty flap and two thoraco-epigastric flaps. In both cases, complete closure was possible without immediate or late complications.
  
  
  CONCLUSIONS
  The local options described in this paper present several potential advantages compared to microsurgical reconstruction, namely they are easier and faster to perform and teach; they provide a good skin color and texture match; they are not associated with distant donor site morbidity; follow-up is usually less cumbersome; the post-operative hospital stay tends to be shorter; they are less costly; they are less prone to complete failure.
  
  
  CONCLUSIONS
  The authors believe that these two patients clearly show that local flaps, although frequently neglected, continue to be valid options for reconstructing large anterior trunk defects, even in the current era of microsurgery enthusiasm.
authors.affiliation: São José Hospital, Lisbon, Portugal. Electronic address: diogo_bogalhao@yahoo.co.uk.
authors.forename: Diogo
authors.initials: D
authors.lastname: Casal
authors.forename: Nuno
authors.initials: N
authors.lastname: Fradinho
authors.forename: Luísa
authors.initials: L
authors.lastname: Ramos
authors.forename: João
authors.initials: J
authors.lastname: Ferreira
authors.forename: Alice
authors.initials: A
authors.lastname: Varanda
authors.forename: Cláudia
authors.initials: C
authors.lastname: Diogo
authors.forename: José
authors.initials: J
authors.lastname: Baltazar
authors.forename: Mário
authors.initials: M
authors.lastname: Fernandes
authors.forename: Carlos
authors.initials: C
authors.lastname: Correia
authors.forename: Maria-Angélica
authors.initials: MA
authors.lastname: Almeida