(P 318) BURIED DE-EPITHELIALIZED FLAP RECONSTRUCTION AFTER WIDE EXCISION OF THIGH SARCOMAS: EARLY EXPERIENCE FROM A SPECIALIZED SARCOMA SURGERY UNIT

Objective: Wound complications after wide excision of thigh soft tissue sarcomas (STS) may impair functional recovery and quality of life. Obliteration of dead space is essential to reduce this risk. This study reports early outcomes of buried de-epithelialized flap reconstruction in selected cases.

Methods: Since 2024, this technique has been adopted at IRCCS Humanitas Research Hospital (Rozzano, Milan, Italy). Five patients underwent wide excision for thigh STS followed by buried de-epithelialized flap reconstruction. All received physiatric evaluation and post-discharge rehabilitation.

Results: Median age was 66 years (54–82). Histologies included Undifferentiated Pleomorphic Sarcoma (UPS, n=2), Myxofibrosarcoma (MFS, n=1), Leiomyosarcoma (LMS, n=1), and Solitary Fibrous Tumor (SFT, n=1). All were FNCLCC grade 3. Median tumor size was 14.0 cm (9.5–18.5). Three patients received neoadjuvant chemotherapy, including two with concurrent radiotherapy. Two patients, including an elderly and symptomatic case, received no preoperative treatment. All cases required en bloc resection of the involved muscle compartment and of the femoral periosteum. Median operative time was 212 minutes (172–254). One patient developed a superficial wound dehiscence, managed conservatively. No deep infections, seromas, bone exposure, or reoperations were observed. Median length of hospital stay (LOS) was 9 days (7–15). All patients regained ambulation with one or two crutches after rehabilitation. Patient data are summarized in Table 1.

Conclusion: Buried de-epithelialized flap is a reliable option in selected thigh sarcomas when other plastic reconstructions are excluded. In this series, it showed low morbidity and favorable functional outcomes.

Patient data