Reconstruction Of Pelvic Defects Research Articles

Reconstruction of pelvic defects with polypropylene mesh following resection of primary tumors – A case series

IntroductionBone and soft-tissue sarcomas arising from the pelvis are difficult to deal with since they present with a large and destructive lesion at the time of presentation, and they often involve neurovascular structures. Internal hemipelvectomy involves the removal of the innominate bone with the adjacent muscles. This study aims to analyze the functional outcome of a patient following internal hemipelvectomy and reconstruct the weight-bearing dome with polypropylene mesh. MethodsBetween June 2021 and December 2021, 3 patients with large pelvic tumors were operated on by internal hemipelvectomy. Wide resection of the tumor was done, and the periacetabular area was reconstructed with polypropylene mesh. The outcome was analyzed at six months and last follow up at August 2022. ResultIn our case series of 3 patients, the average age was 41 years (21–62 years). The male: female ratio is 2:1. The cases were followed up for a mean of 10.33 months(9-12 months). There change in VAS score following surgery up to the 6-month postoperative period (p ​= ​0.0019), and The increase in HHS during the 6-month postoperative period (p ​= ​0.0019) were statistically significant. At final follow up, all patients have acceptable gait, and able to mobilize with walking aids in two patients and without walking aid in one patient. ConclusionInternal hemipelvectomy, although a moribund surgery for the patient of a primary tumor of the pelvis. Reconstruction with the help of polypropylene mesh promises cost-effective and satisfactory outcomes to patients where floor-level activities play an important role in the activity of daily living.

Primary and secondary reconstruction after surgery of the irradiated pelvis using a gracilis muscle flap transposition

Introduction The aim of this study is to describe our experience with reconstruction of pelvic defects after surgery for previously irradiated malignancies using a gracilis muscle flap transposition. Patients and methods Between 1993 and 2002, 25 patients were treated by primary ( n=7) or secondary reconstruction ( n=18) using a gracilis muscle transfer. All patients were previously irradiated with a median dosage of 50 Gy. Results Direct reconstruction following resection of the tumour was accompanied with minor complications in three patients and without major complications. Median time to complete healing of the donor site and perineal defect was 11 and 46 days, respectively. Reconstruction of persistent perineal infections resulted in minor complications at the donor site ( n=3) and at the perineal wound ( n=11). Three patients experienced a major complication. Median time to complete healing of the donor site and perineal defect was, respectively, 17 and 190 days. Necrosis of the gracilis muscle flaps was not observed. Conclusion Direct reconstruction with a gracilis transfer resulted in primary wound healing with low morbidity, hereby preventing potentially disabling persistent defects. After debridement of persistent wounds, indirect reconstruction with gracilis muscle resulted in the majority of patients in healing of the defects with acceptable morbidity.