Aesthetic Reconstruction of Secondary Wounds after Extended Resection of Dermatofibrosarcoma Protuberans: A Retrospective Study in One Center

TL;DR

This study examines surgical outcomes and reconstruction methods for dermatofibrosarcoma protuberans, focusing on recurrence rates and aesthetic results.

Contribution

The paper provides a retrospective analysis of DFSP surgical treatment and wound reconstruction techniques in a single center.

Findings

Wide local excision with negative margins achieved favorable outcomes in classical DFSP cases.

Flap reconstruction resulted in better aesthetic and functional outcomes compared to split-skin grafts.

One case experienced local recurrence, and another had metastasis and death during follow-up.

Abstract

Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue malignancy with aggressive growth.

To summarize the surgical treatment and results of DFSP based on a case series and literature review.

Seventeen DFSP cases were analyzed retrospectively at our hospital from June 2016 to December 2022, including 14 males and 3 females. All these cases were treated by wide local excision with negative margins. Postoperative follow‐up was performed to observe recurrence, survival, and the effect of wound repair.

Routine postoperative pathology confirmed the morphological subtypes of these cases, including 12 cases of classical DFSP, 3 cases of DFSP‐fibrosarcoma, 1 case of myxoid, and 1 case of Bednar. The median defect size was 72 cm2 (interquartile range 20–750 cm2). All patients required split skin (47.1%) or local flap (52.9%) to reconstruct the soft tissue defect caused by tumor resection. All split‐skin grafts were viable, and one flap case had marginal necrosis, which healed by dressing change. After 6–32 months of follow‐up, local recurrence occurred in 1 case, and extensive intra‐abdominal metastasis and death occurred in another case.

Wide local excision with negative margins can achieve a favorable prognosis in classical DFSP. The use of flaps for reconstruction results in better appearance and function.

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