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In recent years, multidisciplinary treatment advances have made limb salvage possible even in cases of recurrent malignant tumors. The key to prevent deep infection is successful wound closure. We inv...estigated reconstruction techniques and clinical outcomes after wide resections of soft tissue tumors in 146 patients. There were 103 properly resected primary tumors, 15 improperly resected primary tumors, and 28 recurrent tumors. Among 107 cases in which direct wound closure was performed, 105 epithelialized without additional surgery other than secondary suturing, while 2 required additional surgery. In contrast to the 80％ of properly resected primary tumor cases that employed direct wound closure, among improperly resected primary tumors, only 33％ employed direct wound closure, while flaps were required in 40％. All recurrent cases that required reconstruction employed skin flap surgery. In improperly resected cases, preparing for skin reconstruction is essential. In recurrent cases, preparation must be made for flap reconstruction.
近年，悪性骨軟部腫瘍の集学的治療の進歩により再発症例においても患肢温存が可能になってきている．創閉鎖の成否は深部感染の予防の鍵を握っている．今回我々は，146 人の軟部腫瘍広範切除後患者の再建法と臨床成績を調査した．初回適切切除は103 例，初回不適切切除は15例，再発は28例であった．直接縫合が行えた107 症例のうち105 例は二次縫合以外の追加手術なしで上皮化したが，2 例で追加再手術を要した．適切切除症例では80％で直接縫合が行えたのに対して，不適切切除症例では33％しか直接縫合が行えず，40％で皮弁を要した．再発例で再建を要する場合は全て皮弁術であった．不適切切除症例は皮膚再建の準備が必要である．再発症例は皮弁による再建を準備すべきである．続きを見る
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