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Forequarter amputation with fasciocutaneous deltoid flap reconstruction for malignant tumors of the upper extremity

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Abstract

Background: Malignant tumors of the upper extremity involving a considerable portion of the medial axillary wall may require forequarter amputation to achieve gross resection of tumor. These resections frequently leave a large defect, often requiring a split thickness skin graft or free flap to close the wound. To address this problem of wound closure, we have modified our technique and devised a reconstructive component as part of our forequarter amputation procedure.

Methods: The medical records of seven patients who underwent forequarter amputation and fasciocutaneous deltoid flap reconstruction between 1982 and 1994 were reviewed.

Results: All the amputation sites were completely closed with a fasciocutaneous deltoid flap without the use of additional skin grafts or free flaps. After a median follow-up of 12 months, there were no local recurrences. Three patients (43%) are alive and disease free 5, 12, and 19 months after their forequarter amputation. One patient is alive with disease after 14 months. The remaining three patients died of their disease.

Conclusion: The fasciocutaneous deltoid flap is technically easy to perform, provides wound coverage without the use of skin grafts, and is especially useful for tumors involving the media axillary wall and in patients with previous axillary radiation.

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Authors and Affiliations

  1. From the Division of Surgical Oncology, Department of Surgery, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Roswell Park Cancer Institute and Buffalo VA Medical Center, Buffalo, New York, USA

    Carmine M. Volpe MD, Steven Peterson MD, Ralph J. Doerr MD & Constantine P. Karakousis MD, PhD

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  1. Carmine M. Volpe MD
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  2. Steven Peterson MD
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  3. Ralph J. Doerr MD
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  4. Constantine P. Karakousis MD, PhD
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Volpe, C.M., Peterson, S., Doerr, R.J. et al. Forequarter amputation with fasciocutaneous deltoid flap reconstruction for malignant tumors of the upper extremity. Annals of Surgical Oncology 4, 298–302 (1997). https://doi.org/10.1007/BF02303578

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  • DOI: https://doi.org/10.1007/BF02303578

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