A 60-year-old female with the initial diagnosis of acute myelogenous leukemia was presented to our clinic with an abscess and surrounding erysipelas on the left lower leg (Figure 4a ). A first excision and debridement of the soft tissue was performed exposing the extensor tendons with a defect size of 6x5 cm (Figure 4b ). Vacuum therapy was applied. Due to the initial and ongoing chemotherapy (idarubicin and cytosin-arabinoside) with a depleted hematological cell status, we decided not to perform a reconstructive procedure with a loco-regional or even free flap, but to repeat the debridement and vacuum therapy for the following 10 weeks. With a satisfying granulation of the wound, we finally closed the defect with skin grafts during a chemotherapeutic interval (Figure 4c ). Although, the wound healing was prolonged, the patient could be discharged with finally good results to receive further allogenic stem cell transplantation in an external clinic.
A 57-year-old male patient with the initial diagnosis of an advanced malignant melanoma on the left foot was operated in our department with an excision in sano of the tumor and closing of the defect by performing a free anterolateral thigh flap (ALTP). However, diagnostic lymph node biopsy was performed as well and following positive histopathology findings, a groin dissection, which was performed without complications, was necessary. The vascular femoral structures were covered by a transposition of the sartorius muscle. As a matter of fact, the patient could be discharged within five days after an uncomplicated wound healing.\nOver the course of time, chemotherapy and radiotherapy was conducted on the affected groin by the department of dermatology. Unfortunately, positive signs of lymph metastasis were detected in the groin region again, thereby requiring the necessity of another operation for the removal of all stationary lymph nodes and subcutaneous tissue. This time wound healing was prolonged due to the immunocompromised status of the patient and the impaired skin in the groin after radiotherapy. With the formation of a chronic seroma regular puncture was necessary, which led to chronic lympho-edema, recurring erysipelas and a frequent re-hospitalisation of the patient. Finally, we decided together with the patient to re-operate the radiated groin. After several debridements the defect was closed by performing loco-regional advancement flaps. The final wound healing was acceptable with only a small dehiscence and no further seroma so far. Chemotherapy was continued by the department of dermatology after the patient had been discharged.