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 50-year-old female diagnosed with B-cell non-Hodgkin lymphoma undergoing chemotherapy with rituximab, cyclophosphamide, vincristine, doxorubicin and high-dosage prednisone was presented to our department with a massive and painful swelling in the cubital area of her left arm after an extravasate with doxorubicin. As an initial surgical treatment, we incised the wound following local debridement. Within 7 days of appropriate treatment with daily wound lavage and antibiotic therapy, the affected wound area impressed with nearly complete necrosis. Therefore, necrectomy of the necrotic tissue was performed revealing a tissue defect of the complete proximal third of the left palmar forearm. After a prolonged hospitalization coupled with several repetitive debridements, antibiotic therapy, as well as the immobilization of the left arm in a cast, the wound finally appeared vital and surgically clean. We decided to close the wound by performing a free parascapular flap to the left forearm (Figure 1 ). Perioperatively, the patient received her regular prednisone dosage plus an extra-dosage during surgery. Both the flap and the wound healing were monitored carefully. After 5 days, a small dehiscence with serous outflow on the proximal wound occurred. After daily lavage and alginate wound dressing commenced, the wound healing was uncomplicated and finally, the patient could be discharged after a hospitalization period of nearly 10 weeks.