title: A simplified approach to reconstruction of hemipelvectomy defects with lower extremity free fillet flaps to minimize ischemia time.
abstract: External hemipelvectomy associated with trauma or during the operative management of musculoskeletal sarcomas may yield a soft tissue defect that can only be sufficiently covered by free tissue transfers. The application of "spare-parts surgery," such as a fillet of leg or thigh flap, uses distal uninvolved parts that are otherwise viable tissues as donor tissues to cover defects. This concept has great utility to achieve soft tissue coverage in challenging cases, such as hemipelvectomy. However, during such complicated and time-consuming cases, prolonged ischemia time of the proposed donor tissues can be problematic. We describe a technique developed by the senior author (SJK) that minimizes the ischemia time of donor free tissues during external hemipelvectomy. This technique is applicable to other surgeries where filleted spare parts are the donor-site source for free tissue transfer.
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bibbo
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery, Cooper University Health Care, Camden, NJ, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Newman
authors.affiliation: Department of Orthopaedic Surgery, Cooper University Health Care, Camden, NJ, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Lackman
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA. Electronic address: stephen.kovach@uphs.upenn.edu.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kovach
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery; D058752:Free Tissue Flaps; D006428:Hemipelvectomy; D006801:Humans; D007511:Ischemia; D007890:Leiomyosarcoma / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000473:pathology / Q000601:surgery; D010384:Pelvic Bones / Q000473:pathology* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*
keywords: Fillet; Free flap; Hemipelvectomy; Ischemia time; Microsurgery; Reconstruction