Locoregional Flaps in Oncoreconstruction at a Tertiary Cancer Centre in North East India: a Review Through a Plastic Sur
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ORIGINAL ARTICLE
Locoregional Flaps in Oncoreconstruction at a Tertiary Cancer Centre in North East India: a Review Through a Plastic Surgeon’s Eye Sumanjit S. Boro 1 & Ashok Kumar Das 2 & Joydeep Purakayastha 3 & Anil K. Mathew 2 & Vinay Mamidala 3 Received: 5 March 2020 / Accepted: 17 June 2020 # Indian Association of Surgical Oncology 2020
Abstract Local flaps are important parts of oncoreconstruction. The idea of writing this article is to give knowledge to my fellow aspiring plastic surgeons about the common locoregional flaps that are essentially done in a tertiary cancer centre. This is a retrospective study carried out in the Department of Plastic Surgery, Dr. B Borooah Cancer Institute, Guwahati, from May 2018 to April 2019. Musculoskeletal and soft tissue, head and neck and thorax and gynaecological malignancies which required locoregional flaps for reconstruction were taken up for the study. Flap reconstructions performed by oncosurgeons are not included in the study. We have done a total of 74 locoregional reconstructions during this 12-month period apart from 43 free tissue transfers. In our study, age ranged from 12 to 84 years. Most commonly performed flap during this time was pectoralis major myocutaneous flap. Complications of various flaps were assessed. Out of the 74 flaps, total necrosis of one flap occurred, and re-surgery was required in one case. Most of the oncosurgeons have a good idea of locoregional reconstructions in cancer centres. In such centres, the need of plastic surgeon for locoregional reconstruction is mainly for complex reconstructions and unfamiliar anatomic locations, for second flap after initial local flap failure or after free flap–related complications. Keywords Local flap, . Oncoreconstruction, . Plastic surgeon
Introduction Oncoreconstruction is a complex surgical procedure requiring sound knowledge of anatomy, physiology, oncology and plastic surgery. Plastic surgery represents a small but critical component of the comprehensive care of cancer patients. The primary role of a plastic surgeon in the treatment of cancer patients is to extend the ability of other surgeons and specialists to more radically treat cancer, offering patients the best opportunity for cure. With better resection and better reconstruction, we can
expect a better quality of life for cancer patients [1]. As a plastic surgeon, our services are required for all branches of oncology, mostly for musculoskeletal, head and neck, gynaecological, genitourinary, thoracic and abdominal wall malignancies. The choice of method of reconstruction depends on a lot of factors like the size and the site of the defect, the projected functional morbidity, the cause of the defect, the medical history of the patient and the patient’s wish. Coordination of the oncosurgeon and plastic surgeon is a must for a good patient outcome.
* Sumanjit S. Boro [email protected]
Vinay Mamidala [email protected] 1
Joydeep Purakayastha [email protected]
Department of Plastic Surgery, Dr B. Borooah Cancer Instit
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