Background: Skin grafting is one of the simplest techniques of providing skin cover following enbloc resection of soft tissue sarcomas on extremities. But many authors have questioned the tolerance of skin graft to post operative radiotherapy.

Aim: To assess the integrity of skin grafts following post operative radiotherapy for soft tissue sarcomas on extremities.

Material and methods: During the period between 1997 and 2003, 10 patients received postoperative external beam radiotherapy following excision of soft tissue sarcomas on extremities and skin grafting at this regional soft tissue sarcoma unit. Age of these patients ranged from 26 years to 92 years. Malignant fibrous histiocytoma was the commonly encountered tumour. Commonest site of resection and skin grafting was lower leg. These patients were analysed for interval between skin grafting and radiotherapy, dose, type and fractions of radiation, break in radiotherapy, adjuvant chemotherapy and effect of radiation on skin graft.

Results: One patient developed moist desquamation and two developed dry desquamation during the course of treatment. All acute skin reactions were healed within 3 weeks of completion of radiotherapy. No patients required further soft tissue reconstruction.

Conclusion: Adjuvant external beam radiotherapy can be delivered to skin-grafted areas on extremities following enbloc excision of soft tissue sarcomas without any major complications. Our experience indicates that the radiation reaction can be minimised if the graft is allowed to heal adequately prior to the initiation of radiotherapy.