![]() Significant wound complications that result from a high incidence of infection, dehiscence, or flap necrosis aggravated by the paucity of well-vascularized local soft tissue and systemically immune-compromised patients. ![]() Radical oncological salvage procedures performed in this area can develop Limb salvage remains a major objective in contemporary management ofīony and soft tissue sarcomas of the pelvis and lower extremities. The modified VRAM flaps offer reliable reconstructive tools for coverage of complex groin and thigh defects by providing larger well-vascularized soft tissue with acceptable donor site. All patients were ambulant with good limb functions in terms of walking and gait after adequate rehabilitation, 2 needed support with crutches. All flaps showed complete survival and healing with no ischemic events providing stable coverage. The modifications included a VRAM flap with lateral and tongue-like extension design of the skin paddle (5 cases) or a delayed extended VRAM flap (2 cases). The patients were managed for complicated lower trunk, groin, and upper thigh wounds after resection of three pelvic chondrosarcomas as well as two pelvic and two proximal femur osteosarcomas. Over a period of 4 years (2002–2005), 5 men and 2 women were managed. The authors present modified vertical rectus abdominis musculocutaneous (VRAM) flap techniques to reconstruct extensive defects after debridment of these complicated wounds. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. ![]()
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