Sarcoma patients who have lost a limb due to amputation can benefit from a quicker recovery thanks to an alternative method of restoring skin.
Sarcomas are a group of rare cancers affecting the tissues that connect, support, and surround other body structures and organs.
Surgery is the main treatment for soft tissue sarcoma and surgeons try to remove the cancer without damaging or removing the affected limb. Sometimes, however, limb amputation is recommended if the cancer has returned to the same site.
During limb amputation, surgeons usually reconstruct the area by using skin taken from another part of the body. This can sometimes be challenging if, for example, the site is located next to a major blood vessel or nerve.
In an alternative method used by surgeons at Newcastle Hospitals, tissue that is free from cancer is used to reconstruct the area, instead of being thrown away. Because there is only one wound, recovery time for patients is often shorter with less time spent in hospital and a decreased risk of complications.
Beneficial for patients
A recent review published in the Journal of Plastic, Reconstructive and Aesthetic Surgery– A Single Centre 10-Year Experience Using the Spare Parts Principle for Sarcoma Reconstruction – found that the approach benefitted patients.
The review was written by plastic registrar Dr Sachin Teelucksingh, and plastic surgeons Juan Enrique Berner, Timothy Crowley and Daniel B Saleh. It was supervised by consultant plastic surgeon, Mr Mani Ragbir.
The results were presented by Dr Teelucksingh at the British Association of Plastic, Reconstructive and Aesthetic Surgeons’ (BAPRAS) North East meeting.
Mr Ragbir, who is also president of BAPRAS, said:
“The use of spare parts in sarcoma reconstruction represents a significant shift in our approach to limb-preserving surgery. By maximising the use of available tissues and minimising the need for extensive grafting, we can improve patient outcomes and streamline post-operative care.”
Dr Teelucksingh adds:
“Our research sheds light on the effectiveness of utilising the spare parts principle in sarcoma reconstruction, particularly in cases where preserving the limb through conventional means is challenging. By salvaging and repurposing tissues that would typically be discarded, we can enhance functional outcomes and minimise donor site morbidity for patients.”
David’s story
58-year-old David Brown, a retired train driver hailing from South Shields, underwent removal of malignant melanomas twice before finding out that a lump under his arm was a sarcoma.
David received treatment and was told he may lose his arm, but a limb-preserving operation meant his arm was saved and, after daily radiotherapy, he was given the all-clear from cancer two months later.
Unfortunately, in 2023, David noticed a new lump and was told he would need to undergo a drastic amputation called a forequarter amputation, where the arm, shoulder blade and collar bone is removed.
Life-saving operation
On 1 October 2023, David underwent the life-saving operation, which was carried out by Mr Ragbir.
David says:
“When they first told me I may lose my arm, I responded that if that happened, I would not be able to live. I could not imagine a life as an amputee. However, when the tumours returned and the pain so was severe even morphine couldn’t help, I was keen to go ahead.
“The operation was a success and I’ve never looked back or felt sorry for myself. In fact, just a month afterwards, I was planning six-months on holiday, popping back only to attend hospital appointments and do my washing!”
Over the next few months, David and his wife visited Egypt, India, Gran Canaria, Florida, Bali and Australia.
David continues:
“When I was 13, I had a tattoo on my left forearm. Years later, I was fed up with it and underwent laser surgery, getting rid of all of it but a blob. I was happy that at least the amputation would finally rid me of the tattoo, but due to the spare parts principle the blob is, in fact, now on my shoulder!”
Mr Ragbir added:
“David was a prime candidate for the technique, undergoing a fairly complex procedure. Recovery limited to a single wound rather than multiple meant that David was able to return to daily life more quickly, establishing a new normality. David is an inspiration, and we wish him all the best for the future.”
