Kết quả tạo hình khuyết phần mềm vùng lưng sau cắt bỏ ung thư

Abstract

A retrospective study was conducted on 25 patients who underwent reconstructive surgery for soft tissue defects following wide excision of cutaneous malignancies on the back, at K Hospital from August 2017 to August 2025. Defect sizes ranged from 8×8cm to 20×30cm.The distribution of defect locations was as follows: 48% in the upper third of the back, 16% in the middle third, and 36% in the lower back and sacral region. Various reconstructive methods were employed based on the defect's location and characteristics, including 12 pedicled myocutaneous flaps, 7 perforator flaps, 2 random local flaps, 2 full-thickness skin grafts, and 2 cases of primary closure. Postoperative flap or graft viability was recorded as complete survival in 72% of cases, partial necrosis in 16%, and total necrosis in 12%. Follow-up ranged from 6 to 72 months, with 24 out of 25 patients demonstrating favorable outcomes in terms of scar appearance, thickness, color, contour, and flap texture. Two patients experienced local recurrence of the malignancy. Wide local excision of cutaneous and soft tissue malignancies in the dorsal region frequently results in extensive, deep, and variably located defects. Pedicled myocutaneous flaps and perforator flaps represent reliable reconstructive options following oncologic resection, offering well-vascularized tissue with appropriate color match, thickness, and durability, while maintaining both aesthetic contour and functional integrity. Flap selection is primarily guided by the size and anatomical location of the defect-factors that critically impact reconstructive outcomes. A good postoperative outcome was achieved in 72% of patients immediately after surgery, increasing to 80% at the 6-month follow-up.