C. Radtke

[Stem cells from fatty tissue : A new resource for regenerative medicine?].

While stem cells derived from the bone marrow are well-known in clinical medicine, fatty tissue as a source of mesenchymal stem cells is still the subject of recent research. However, adipose-derived stem cells (ASC) are not only harvested less invasively, i.e. via minimally invasive liposuction, but also yield higher numbers of multipotent stem cells.Due to cell-cell interactions and also because of the very favorable secretion profile of growth factors and cytokines ASCs displayed an extraordinary regenerative potential in recent preclinical and clinical applications and achieved a significantly better healing in ischemic muscle, heart, and brain insults and in impaired wound healing. ASCs enhanced regeneration in skeletal tissues such as cartilage or bone. They also revealed immunomodulatory effects and improved the clinical status in immunological diseases.In conclusion ASCs are comparable to bone marrow-derived stem cells concerning possible applications in clinical medicine.

Weichteilplastische Maßnahmen bei Komplikationen im Schädelbereich

ZusammenfassungAusgedehnte Schädeldefekte entstehen zum einen im Rahmen onkologischer Erkrankungen, posttraumatisch oder postinterventionell. Ein nach der Primär- oder Sekundärversorgung in der Neurochirurgie, Hals-Nasen-Ohren-Heilkunde bzw. Schädelbasischirurgie eintretender komplikationsbehafteter Verlauf mit Weichteilverlusten ergibt die Notwendigkeit eines interdisziplinären plastisch-chirurgischen Komplikationsmanagements. In diesem Übersichtsartikel werden beispielhaft die Möglichkeiten der plastischen Weichteilrekonstruktion anhand repräsentativer Fallbeispiele dargestellt.AbstractTumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.Tumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.

Soft tissue plastic surgery for complications in the skull region

ZusammenfassungAusgedehnte Schädeldefekte entstehen zum einen im Rahmen onkologischer Erkrankungen, posttraumatisch oder postinterventionell. Ein nach der Primär- oder Sekundärversorgung in der Neurochirurgie, Hals-Nasen-Ohren-Heilkunde bzw. Schädelbasischirurgie eintretender komplikationsbehafteter Verlauf mit Weichteilverlusten ergibt die Notwendigkeit eines interdisziplinären plastisch-chirurgischen Komplikationsmanagements. In diesem Übersichtsartikel werden beispielhaft die Möglichkeiten der plastischen Weichteilrekonstruktion anhand repräsentativer Fallbeispiele dargestellt.AbstractTumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.Tumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.

Plastische Rekonstruktion von Strahlenfolgen

In addition to surgical and drug therapy, radiotherapy (or radiation therapy) is one of the three mainstays of modern oncological therapy regimes. It uses ionizing radiation to control tumors by damaging the DNA of cancerous tissue leading to cellular death. Although advances have been made in recent years resulting in a reduced dosage to the surrounding tissues, radiation injuries and tissue-related side effects cannot be completely avoided. Knowledge of the pathophysiology, treatment modalities and interdisciplinary treatment approaches are essential for effective therapy whilst limiting side effects. Surgery within the irradiated area is technically demanding due to tissue alterations and unpredictable wound healing. The plastic reconstructive surgeon either faces the challenge of delayed wound healing following neoadjuvant radiation or chronic radiation-linked changes following previous radiotherapy, which can also occur after a latency period of many years. Reconstructive interventions can be essential to repair deficits of a functional and/or aesthetic nature in order to maintain a high quality of life for oncology patients. This can also be of benefit to patients in a palliative oncological setting to improve daily functions and quality of life.ZusammenfassungDie Bestrahlung der Tumorregion stellt neben der medikamentösen und chirurgischen Therapie die dritte Säule der modernen Onkologie dar. Sie erfuhr innerhalb der letzten Jahre eine rasante technische Weiterentwicklung. Dennoch kann eine Schädigung von gesundem Gewebe im Strahlenfeld nicht gänzlich verhindert werden. Die Kenntnisse über die Pathomechanismen, Strahlendosen und interdisziplinäre Planung der Behandlung sind unabdingbare Voraussetzungen für einen komplikationsarmen Verlauf. Operationen im Strahlenfeld sind durch die strahlenbedingten Gewebealterationen häufig technisch anspruchsvoll und können mit protrahierten Heilungsverläufen verbunden sein. Dabei werden 2 unterschiedliche plastisch-chirurgische Szenarien unterschieden, zum einen die protrahierte Wundheilung nach neoadjuvanter Bestrahlung und zeitnaher elektiver Tumorresektion und zum anderen eine höhergradige chronische Strahlennebenwirkung, die auch nach vielen Jahren der Latenz auftreten kann. Rekonstruktive Eingriffe können notwendig sein, um entstandene Defizite funktioneller und/oder ästhetischer Natur – mit dem Ziel einer möglichst hohen Lebensqualität – zu verbessern. Diese können auch im Kontext einer palliativen-onkologischen Situation sinnvoll sein, wenn dadurch Verbesserungen im alltäglichen Leben zu erwarten sind.AbstractIn addition to surgical and drug therapy, radiotherapy (or radiation therapy) is one of the three mainstays of modern oncological therapy regimes. It uses ionizing radiation to control tumors by damaging the DNA of cancerous tissue leading to cellular death. Although advances have been made in recent years resulting in a reduced dosage to the surrounding tissues, radiation injuries and tissue-related side effects cannot be completely avoided. Knowledge of the pathophysiology, treatment modalities and interdisciplinary treatment approaches are essential for effective therapy whilst limiting side effects. Surgery within the irradiated area is technically demanding due to tissue alterations and unpredictable wound healing. The plastic reconstructive surgeon either faces the challenge of delayed wound healing following neoadjuvant radiation or chronic radiation-linked changes following previous radiotherapy, which can also occur after a latency period of many years. Reconstructive interventions can be essential to repair deficits of a functional and/or aesthetic nature in order to maintain a high quality of life for oncology patients. This can also be of benefit to patients in a palliative oncological setting to improve daily functions and quality of life.

Plastische Rekonstruktion von Strahlenfolgen@@@Plastic reconstruction of radiation injuries

ZusammenfassungDie Bestrahlung der Tumorregion stellt neben der medikamentösen und chirurgischen Therapie die dritte Säule der modernen Onkologie dar. Sie erfuhr innerhalb der letzten Jahre eine rasante technische Weiterentwicklung. Dennoch kann eine Schädigung von gesundem Gewebe im Strahlenfeld nicht gänzlich verhindert werden. Die Kenntnisse über die Pathomechanismen, Strahlendosen und interdisziplinäre Planung der Behandlung sind unabdingbare Voraussetzungen für einen komplikationsarmen Verlauf. Operationen im Strahlenfeld sind durch die strahlenbedingten Gewebealterationen häufig technisch anspruchsvoll und können mit protrahierten Heilungsverläufen verbunden sein. Dabei werden 2 unterschiedliche plastisch-chirurgische Szenarien unterschieden, zum einen die protrahierte Wundheilung nach neoadjuvanter Bestrahlung und zeitnaher elektiver Tumorresektion und zum anderen eine höhergradige chronische Strahlennebenwirkung, die auch nach vielen Jahren der Latenz auftreten kann. Rekonstruktive Eingriffe können notwendig sein, um entstandene Defizite funktioneller und/oder ästhetischer Natur – mit dem Ziel einer möglichst hohen Lebensqualität – zu verbessern. Diese können auch im Kontext einer palliativen-onkologischen Situation sinnvoll sein, wenn dadurch Verbesserungen im alltäglichen Leben zu erwarten sind.AbstractIn addition to surgical and drug therapy, radiotherapy (or radiation therapy) is one of the three mainstays of modern oncological therapy regimes. It uses ionizing radiation to control tumors by damaging the DNA of cancerous tissue leading to cellular death. Although advances have been made in recent years resulting in a reduced dosage to the surrounding tissues, radiation injuries and tissue-related side effects cannot be completely avoided. Knowledge of the pathophysiology, treatment modalities and interdisciplinary treatment approaches are essential for effective therapy whilst limiting side effects. Surgery within the irradiated area is technically demanding due to tissue alterations and unpredictable wound healing. The plastic reconstructive surgeon either faces the challenge of delayed wound healing following neoadjuvant radiation or chronic radiation-linked changes following previous radiotherapy, which can also occur after a latency period of many years. Reconstructive interventions can be essential to repair deficits of a functional and/or aesthetic nature in order to maintain a high quality of life for oncology patients. This can also be of benefit to patients in a palliative oncological setting to improve daily functions and quality of life.

Regenerative Therapieansätze in der plastischen Chirurgie@@@Regenerative therapy approaches in plastic surgery

ZusammenfassungHintergrundDie Regeneration von durch Trauma oder Krankheit verloren gegangenem Gewebe stellt das Ideal gegenüber der Reparation, bei der an einer anderen Stelle des Körpers ein Hebedefekt entsteht, dar. Durch ein verbessertes Verständnis der zell- und molekularbiologischen Grundlagen der Heilung haben sich in den letzten Jahren verschiedene regenerative Therapieansätze entwickelt.Ziel der ArbeitEs soll eine beispielhafte Darstellung aktueller regenerativer Therapieansätze und deren Wirkung sowie klinische Anwendung erfolgen.Material und MethodenDie Datenbank PubMed wurde nach regenerativen Ansätzen in der plastischen Chirurgie durchsucht und verschiedene Verfahren werden dargestellt.ErgebnisseInsbesondere zellbasierte Ansätze, bei denen bevorzugt autologe mesenchymale Stammzellen aus dem Fettgewebe eingesetzt werden, zeigen hervorragende Heilerfolge mit minimalem Hebedefekt. Doch auch wachstumsfaktorbasierte Ansätze oder die Verwendung von thrombozytenreichem Plasma führen zu außerordentlich guten Ergebnissen im Bereich der Wund- oder Knochenheilung.DiskussionDurch Einbringen verschiedener Zellen oder Moleküle lassen sich unter Ausnutzung biologischer Mechanismen die regenerativen Fähigkeiten des adulten Organismus verbessern. Nicht nur in der rekonstruktiven, sondern auch in der ästhetischen Chirurgie finden viele Verfahren bereits klinische Anwendung. Doch sollten die Erfolge nicht über das potenzielle Risiko, das sowohl zell- als auch wachstumsfaktorbasierten Ansätzen zu eigen ist, hinwegtäuschen und solche Therapieverfahren bis zum Vorliegen von Langzeiterfahrungen sorgfältig indiziert werden.AbstractBackgroundThe regeneration of tissue lost due to trauma or disease is considered as being ideal for reconstruction with respect to repair in which a donor defect arises in a different part of the body. Through a better understanding of the cellular and molecular mechanisms of healing, possibilities for regenerative therapies have been developed in recent years.ObjectivesTo give an exemplary representation of current regenerative therapy approaches and their effect and clinical application.Material and methodsThe PubMed database was searched for different regenerative approaches in plastic surgery and various methods are presented in this article.ResultsCell-based approaches, in which autologous mesenchymal stem cells from adipose tissue are preferably used, led to excellent healing results with minimal donor site morbidity. Likewise, growth factor-based approaches or the use of platelet-rich plasma achieve very good results in the field of wound and bone healing. DiscussionBy using different cells or molecules and thus taking advantage of biological mechanisms, the regenerative capabilities of adult organisms could be improved. Many methods have already been implemented in clinical practice, not only in reconstructive but also in aesthetic surgery. However, the success should not conceal the potential risk that is inherent in both cell and growth factor-based approaches. Until long-term experiences of such therapies have been acquired, they should be used cautiously.BACKGROUND The regeneration of tissue lost due to trauma or disease is considered as being ideal for reconstruction with respect to repair in which a donor defect arises in a different part of the body. Through a better understanding of the cellular and molecular mechanisms of healing, possibilities for regenerative therapies have been developed in recent years. OBJECTIVES To give an exemplary representation of current regenerative therapy approaches and their effect and clinical application. MATERIAL AND METHODS The PubMed database was searched for different regenerative approaches in plastic surgery and various methods are presented in this article. RESULTS Cell-based approaches, in which autologous mesenchymal stem cells from adipose tissue are preferably used, led to excellent healing results with minimal donor site morbidity. Likewise, growth factor-based approaches or the use of platelet-rich plasma achieve very good results in the field of wound and bone healing. DISCUSSION By using different cells or molecules and thus taking advantage of biological mechanisms, the regenerative capabilities of adult organisms could be improved. Many methods have already been implemented in clinical practice, not only in reconstructive but also in aesthetic surgery. However, the success should not conceal the potential risk that is inherent in both cell and growth factor-based approaches. Until long-term experiences of such therapies have been acquired, they should be used cautiously.

Regenerative therapy approaches in plastic surgery

ZusammenfassungHintergrundDie Regeneration von durch Trauma oder Krankheit verloren gegangenem Gewebe stellt das Ideal gegenüber der Reparation, bei der an einer anderen Stelle des Körpers ein Hebedefekt entsteht, dar. Durch ein verbessertes Verständnis der zell- und molekularbiologischen Grundlagen der Heilung haben sich in den letzten Jahren verschiedene regenerative Therapieansätze entwickelt.Ziel der ArbeitEs soll eine beispielhafte Darstellung aktueller regenerativer Therapieansätze und deren Wirkung sowie klinische Anwendung erfolgen.Material und MethodenDie Datenbank PubMed wurde nach regenerativen Ansätzen in der plastischen Chirurgie durchsucht und verschiedene Verfahren werden dargestellt.ErgebnisseInsbesondere zellbasierte Ansätze, bei denen bevorzugt autologe mesenchymale Stammzellen aus dem Fettgewebe eingesetzt werden, zeigen hervorragende Heilerfolge mit minimalem Hebedefekt. Doch auch wachstumsfaktorbasierte Ansätze oder die Verwendung von thrombozytenreichem Plasma führen zu außerordentlich guten Ergebnissen im Bereich der Wund- oder Knochenheilung.DiskussionDurch Einbringen verschiedener Zellen oder Moleküle lassen sich unter Ausnutzung biologischer Mechanismen die regenerativen Fähigkeiten des adulten Organismus verbessern. Nicht nur in der rekonstruktiven, sondern auch in der ästhetischen Chirurgie finden viele Verfahren bereits klinische Anwendung. Doch sollten die Erfolge nicht über das potenzielle Risiko, das sowohl zell- als auch wachstumsfaktorbasierten Ansätzen zu eigen ist, hinwegtäuschen und solche Therapieverfahren bis zum Vorliegen von Langzeiterfahrungen sorgfältig indiziert werden.AbstractBackgroundThe regeneration of tissue lost due to trauma or disease is considered as being ideal for reconstruction with respect to repair in which a donor defect arises in a different part of the body. Through a better understanding of the cellular and molecular mechanisms of healing, possibilities for regenerative therapies have been developed in recent years.ObjectivesTo give an exemplary representation of current regenerative therapy approaches and their effect and clinical application.Material and methodsThe PubMed database was searched for different regenerative approaches in plastic surgery and various methods are presented in this article.ResultsCell-based approaches, in which autologous mesenchymal stem cells from adipose tissue are preferably used, led to excellent healing results with minimal donor site morbidity. Likewise, growth factor-based approaches or the use of platelet-rich plasma achieve very good results in the field of wound and bone healing. DiscussionBy using different cells or molecules and thus taking advantage of biological mechanisms, the regenerative capabilities of adult organisms could be improved. Many methods have already been implemented in clinical practice, not only in reconstructive but also in aesthetic surgery. However, the success should not conceal the potential risk that is inherent in both cell and growth factor-based approaches. Until long-term experiences of such therapies have been acquired, they should be used cautiously.BACKGROUND The regeneration of tissue lost due to trauma or disease is considered as being ideal for reconstruction with respect to repair in which a donor defect arises in a different part of the body. Through a better understanding of the cellular and molecular mechanisms of healing, possibilities for regenerative therapies have been developed in recent years. OBJECTIVES To give an exemplary representation of current regenerative therapy approaches and their effect and clinical application. MATERIAL AND METHODS The PubMed database was searched for different regenerative approaches in plastic surgery and various methods are presented in this article. RESULTS Cell-based approaches, in which autologous mesenchymal stem cells from adipose tissue are preferably used, led to excellent healing results with minimal donor site morbidity. Likewise, growth factor-based approaches or the use of platelet-rich plasma achieve very good results in the field of wound and bone healing. DISCUSSION By using different cells or molecules and thus taking advantage of biological mechanisms, the regenerative capabilities of adult organisms could be improved. Many methods have already been implemented in clinical practice, not only in reconstructive but also in aesthetic surgery. However, the success should not conceal the potential risk that is inherent in both cell and growth factor-based approaches. Until long-term experiences of such therapies have been acquired, they should be used cautiously.

Regenerative Therapieansätze in der plastischen Chirurgie

ZusammenfassungHintergrundDie Regeneration von durch Trauma oder Krankheit verloren gegangenem Gewebe stellt das Ideal gegenüber der Reparation, bei der an einer anderen Stelle des Körpers ein Hebedefekt entsteht, dar. Durch ein verbessertes Verständnis der zell- und molekularbiologischen Grundlagen der Heilung haben sich in den letzten Jahren verschiedene regenerative Therapieansätze entwickelt.Ziel der ArbeitEs soll eine beispielhafte Darstellung aktueller regenerativer Therapieansätze und deren Wirkung sowie klinische Anwendung erfolgen.Material und MethodenDie Datenbank PubMed wurde nach regenerativen Ansätzen in der plastischen Chirurgie durchsucht und verschiedene Verfahren werden dargestellt.ErgebnisseInsbesondere zellbasierte Ansätze, bei denen bevorzugt autologe mesenchymale Stammzellen aus dem Fettgewebe eingesetzt werden, zeigen hervorragende Heilerfolge mit minimalem Hebedefekt. Doch auch wachstumsfaktorbasierte Ansätze oder die Verwendung von thrombozytenreichem Plasma führen zu außerordentlich guten Ergebnissen im Bereich der Wund- oder Knochenheilung.DiskussionDurch Einbringen verschiedener Zellen oder Moleküle lassen sich unter Ausnutzung biologischer Mechanismen die regenerativen Fähigkeiten des adulten Organismus verbessern. Nicht nur in der rekonstruktiven, sondern auch in der ästhetischen Chirurgie finden viele Verfahren bereits klinische Anwendung. Doch sollten die Erfolge nicht über das potenzielle Risiko, das sowohl zell- als auch wachstumsfaktorbasierten Ansätzen zu eigen ist, hinwegtäuschen und solche Therapieverfahren bis zum Vorliegen von Langzeiterfahrungen sorgfältig indiziert werden.AbstractBackgroundThe regeneration of tissue lost due to trauma or disease is considered as being ideal for reconstruction with respect to repair in which a donor defect arises in a different part of the body. Through a better understanding of the cellular and molecular mechanisms of healing, possibilities for regenerative therapies have been developed in recent years.ObjectivesTo give an exemplary representation of current regenerative therapy approaches and their effect and clinical application.Material and methodsThe PubMed database was searched for different regenerative approaches in plastic surgery and various methods are presented in this article.ResultsCell-based approaches, in which autologous mesenchymal stem cells from adipose tissue are preferably used, led to excellent healing results with minimal donor site morbidity. Likewise, growth factor-based approaches or the use of platelet-rich plasma achieve very good results in the field of wound and bone healing. DiscussionBy using different cells or molecules and thus taking advantage of biological mechanisms, the regenerative capabilities of adult organisms could be improved. Many methods have already been implemented in clinical practice, not only in reconstructive but also in aesthetic surgery. However, the success should not conceal the potential risk that is inherent in both cell and growth factor-based approaches. Until long-term experiences of such therapies have been acquired, they should be used cautiously.BACKGROUND The regeneration of tissue lost due to trauma or disease is considered as being ideal for reconstruction with respect to repair in which a donor defect arises in a different part of the body. Through a better understanding of the cellular and molecular mechanisms of healing, possibilities for regenerative therapies have been developed in recent years. OBJECTIVES To give an exemplary representation of current regenerative therapy approaches and their effect and clinical application. MATERIAL AND METHODS The PubMed database was searched for different regenerative approaches in plastic surgery and various methods are presented in this article. RESULTS Cell-based approaches, in which autologous mesenchymal stem cells from adipose tissue are preferably used, led to excellent healing results with minimal donor site morbidity. Likewise, growth factor-based approaches or the use of platelet-rich plasma achieve very good results in the field of wound and bone healing. DISCUSSION By using different cells or molecules and thus taking advantage of biological mechanisms, the regenerative capabilities of adult organisms could be improved. Many methods have already been implemented in clinical practice, not only in reconstructive but also in aesthetic surgery. However, the success should not conceal the potential risk that is inherent in both cell and growth factor-based approaches. Until long-term experiences of such therapies have been acquired, they should be used cautiously.

Haut- und Weichteilkomplikationen nach tumororthopädischen Eingriffen

ZusammenfassungDie interdisziplinäre Zusammenarbeit von Orthopäden und plastischen Chirurgen ist in der rekonstruktiven Chirurgie der Extremitäten sowohl bei traumatologisch-orthopädischen Frakturen mit ausgedehnten Weichteilschäden als auch bei muskuloskeletalen Tumorresektionen indiziert. Der Beitrag stellt insbesondere die Rekonstruktionen nach Tumorresektionen dar, wobei die enge Zusammenarbeit bereits in der präoperativen Planung wichtig ist, um das gemeinsame Vorgehen unter besonderer Berücksichtigung ggf. notwendiger adjuvanter Therapien zu diskutieren. Je nach Lokalisation und Ausmaß tumorchirurgischer Resektionen stehen zur Weichteildeckung sowie zur funktionellen Rekonstruktion verschiedene Möglichkeiten zur Verfügung. Insbesondere müssen einzeitige gegenüber zweizeitigen Verfahren abgewogen werden.AbstractInterdisciplinary collaboration between orthopedic and plastic surgeons is indicated in reconstructive surgery of the extremities for both traumatic orthopedic fractures with extensive soft tissue damage and musculoskeletal tumor resection. We want to emphasize the need for close cooperation starting in the preoperative planning for reconstruction after tumor resection in order to discuss and establish a unified approach. This is particularly important to establish a joint approach with special consideration of possibly necessary adjuvant therapies. One collaborative approach is for the orthopedic surgeon to resect the tumor and the plastic surgeon to carry out the defect reconstruction for exclusive soft tissue coverage including flap surgery as well as for functional reconstruction depending on the location and extent of tumor resection. Thus, careful preoperative and postoperative communication on the precise location, extent of tumor resection and the therapy timing between the orthopedic surgeon and the plastic surgeon will allow the most effective subsequent repair of the resection site.Interdisciplinary collaboration between orthopedic and plastic surgeons is indicated in reconstructive surgery of the extremities for both traumatic orthopedic fractures with extensive soft tissue damage and musculoskeletal tumor resection. We want to emphasize the need for close cooperation starting in the preoperative planning for reconstruction after tumor resection in order to discuss and establish a unified approach. This is particularly important to establish a joint approach with special consideration of possibly necessary adjuvant therapies. One collaborative approach is for the orthopedic surgeon to resect the tumor and the plastic surgeon to carry out the defect reconstruction for exclusive soft tissue coverage including flap surgery as well as for functional reconstruction depending on the location and extent of tumor resection. Thus, careful preoperative and postoperative communication on the precise location, extent of tumor resection and the therapy timing between the orthopedic surgeon and the plastic surgeon will allow the most effective subsequent repair of the resection site.

[Skin and soft tissue complications after orthopedic interventions on tumors : interdisciplinary management].

ZusammenfassungDie interdisziplinäre Zusammenarbeit von Orthopäden und plastischen Chirurgen ist in der rekonstruktiven Chirurgie der Extremitäten sowohl bei traumatologisch-orthopädischen Frakturen mit ausgedehnten Weichteilschäden als auch bei muskuloskeletalen Tumorresektionen indiziert. Der Beitrag stellt insbesondere die Rekonstruktionen nach Tumorresektionen dar, wobei die enge Zusammenarbeit bereits in der präoperativen Planung wichtig ist, um das gemeinsame Vorgehen unter besonderer Berücksichtigung ggf. notwendiger adjuvanter Therapien zu diskutieren. Je nach Lokalisation und Ausmaß tumorchirurgischer Resektionen stehen zur Weichteildeckung sowie zur funktionellen Rekonstruktion verschiedene Möglichkeiten zur Verfügung. Insbesondere müssen einzeitige gegenüber zweizeitigen Verfahren abgewogen werden.AbstractInterdisciplinary collaboration between orthopedic and plastic surgeons is indicated in reconstructive surgery of the extremities for both traumatic orthopedic fractures with extensive soft tissue damage and musculoskeletal tumor resection. We want to emphasize the need for close cooperation starting in the preoperative planning for reconstruction after tumor resection in order to discuss and establish a unified approach. This is particularly important to establish a joint approach with special consideration of possibly necessary adjuvant therapies. One collaborative approach is for the orthopedic surgeon to resect the tumor and the plastic surgeon to carry out the defect reconstruction for exclusive soft tissue coverage including flap surgery as well as for functional reconstruction depending on the location and extent of tumor resection. Thus, careful preoperative and postoperative communication on the precise location, extent of tumor resection and the therapy timing between the orthopedic surgeon and the plastic surgeon will allow the most effective subsequent repair of the resection site.Interdisciplinary collaboration between orthopedic and plastic surgeons is indicated in reconstructive surgery of the extremities for both traumatic orthopedic fractures with extensive soft tissue damage and musculoskeletal tumor resection. We want to emphasize the need for close cooperation starting in the preoperative planning for reconstruction after tumor resection in order to discuss and establish a unified approach. This is particularly important to establish a joint approach with special consideration of possibly necessary adjuvant therapies. One collaborative approach is for the orthopedic surgeon to resect the tumor and the plastic surgeon to carry out the defect reconstruction for exclusive soft tissue coverage including flap surgery as well as for functional reconstruction depending on the location and extent of tumor resection. Thus, careful preoperative and postoperative communication on the precise location, extent of tumor resection and the therapy timing between the orthopedic surgeon and the plastic surgeon will allow the most effective subsequent repair of the resection site.