Sliding free transverse rectus abdominis myocutaneous flap for closure of a massive abdominal wall defect: a case report
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary t...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
Microsurgery
Year: 2019, Volume: 39, Issue: 2, Pages: 174-177 |
| ISSN: | 1098-2752 |
| DOI: | 10.1002/micr.30309 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1002/micr.30309 Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.30309 
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| Author Notes: | Annika Senghaas MD, Thomas Kremer MD, Volker J. Schmidt MD, Leila Harhaus MD, Christoph Hirche MD, Ulrich Kneser MD, Amir K. Bigdeli MD |
| Summary: | Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration. Finally, the composite defect was successfully reconstructed through a contralateral extended free transverse rectus abdominis myocutaneus (TRAM) flap (50 cm × 38 cm). An arterio-venous loop to the superficial femoral vessels using the great saphenous vein was necessary to allow the flap to reach the defect. Postoperatively, a minor wound healing disorder of the flap was successfully treated with split skin grafting. Six month after surgery, the patient presented with a completely healed flap coverage area and a small abdominal hernia without the need of further surgical revision. This case illustrates the use of a sliding free TRAM flap for closure of a massive abdominal wall defect. |
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| Item Description: | First published: 16 February 2018 Gesehen am 05.12.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1098-2752 |
| DOI: | 10.1002/micr.30309 |