Objective  To evaluate the application of a pedicled skin flap in wound healing after the resection of soft tissue malignant tumors in the limbs and trunk.

  Methods  A total of 15 patients with soft tissue sarcoma were treated at Affiliated Cancer Hospital of Xinjiang Medical University between January 2019 and January 2021, including 3 cases of pleomorphic undifferentiated sarcoma, 2 cases of synovial sarcoma, 2 cases of leiomyosarcoma, 2 cases of liposarcoma, 2 cases of epithelioid sarcoma, 2 cases of skin squamous cell carcinoma, and 2 cases of malignant melanoma of the heel. They were selected for expanded resection in accordance with existing guidelines. Direct suture or skin grafting could not be performed due to the large soft tissue defect present after resection. According to the location of the wound defect after tumor resection, a suitable skin flap with vascular pedicle was selected for repair.

  Result  One case of heel squamous cell carcinoma was treated using a retrograde sural nerve nutrient flap, and its distal end became necrotic. After debridement, the wound was successfully treated with a local arbitrary rotation flap and skin grafting. One case of retrograde sartorius myocutaneous flap had local blackening 2 days after operation, and the whole flap was found to be completely necrotic 1 week after operation. After debridement, the wound was treated with local arbitrary rotation flap and skin grafting. All the other flaps healed in one stage. During the follow-up period of 6-24 months, 4 patients died of multiple metastases, whereas the rest survived. No local tumor recurrence was observed during the follow-up.

  Conclusions  A sufficient resection range must be ensured when soft tissue malignant tumors of the limbs and trunk are treated. The range and depth need to reach the safe surgical boundary. The skin defect and residual cavity left after extensive resection is large, and a vascularized skin flap can effectively fill and cover the wound and reduce infection. This method can accelerate the recovery of patient.