Sarcoma reconstruction

The first consultation is usually with oncology. Your case is discussed by the hospital’s multidisciplinary sarcoma team, in whose weekly meetings we participate.

Biopsies, further investigations or treatment before surgery may be needed. Tumour removal may involve general surgery, orthopaedic surgery, plastic surgery or several teams working together. Institut Ruiz Castilla (IRC) provides the reconstruction.

We usually perform or begin reconstruction during tumour removal. If we need to wait for results that will determine whether further tissue must be removed, we may postpone definitive coverage.

During this interval, we use appropriate wound dressings or negative pressure wound therapy when indicated, avoiding the use of tissue that might need to be removed during further surgery.

Sarcomas are a diverse group of cancers. The priority is to treat the disease while aiming for the best possible survival and quality of life.

Reconstruction aims to preserve or restore function and address appearance without compromising tumour removal or other treatments. A full return to your previous condition is not always possible.

Radiotherapy may influence the reconstructive options. We assess the quality and healing capacity of irradiated tissue; sometimes healthy tissue must be brought in from another part of the body.

If radiotherapy is planned after surgery, we take this into account when choosing tissue coverage and planning the timing of treatment.

Oncology continues to monitor the disease throughout treatment. Institut Ruiz Castilla (IRC) follows the reconstruction and coordinates wound care and rehabilitation with the cancer treatment schedule.

If the oncology team identifies a surgical complication, they refer you back to the reconstructive team.

Activity restrictions may be minor or require several weeks of protection. The area treated, any skin graft or flap, and the underlying structures involved determine positioning, wound care and movement recommendations.

We coordinate wound protection with rehabilitation medicine and physiotherapy. Movement, stretching and splints are adapted to tissue stability and healing progress.

Scarring of the skin and soft tissues can restrict movement, but tendons, muscles and joints may also have adapted to a longstanding limitation. Releasing the skin does not always restore function immediately.

Rehabilitation and the maturation of internal and external scars continue after surgery. Improvement may be partial and gradual.

Possible complications include delayed wound healing, infection, haematomas, seromas, and partial or complete loss of a skin graft or flap. The risks depend on the individual reconstruction.

Alongside explaining these risks, we discuss how they may be managed: wound care and observation for small affected areas, specific treatments, or further surgery when necessary. The available options depend on the cause, extent and tissues available.

Our nursing team provides wound care as often as needed. The medical team monitors healing and determines whether changes in treatment or further procedures are required.

Once there are no open wounds, pain is controlled and your general health allows, we can plan your return home and arrange continued follow-up, provided this is compatible with the next stages of treatment.

Sun protection, moisturising and scar massage are introduced once the team confirms that the wound has healed sufficiently. Silicone sheets or gel may be recommended depending on the area, the surgical technique and how healing progresses.

Care continues until the scars have matured clinically. Scars do not all mature at the same rate, even in the same person. If a scar becomes raised, firm, itchy or develops unfavourably, the Institut Ruiz Castilla (IRC) team will assess whether specific treatment is needed.

Contact us if you notice increasing pain, persistent bleeding, a rapid change in swelling, spreading redness or increasing warmth, fever, discharge, wound opening or any other change that concerns you. You do not need to decide whether it is a complication: the team will assess it.

Institut Ruiz Castilla (IRC) provides on-call medical support 24 hours a day, seven days a week. Medical and administrative contact numbers are included in your care instructions.

If you experience difficulty breathing, chest pain, fainting or another clear emergency, seek urgent medical attention rather than waiting for a scheduled appointment.