Abdominal wall reconstruction using a combination of free tensor fasciae lata and anterolateral thigh myocutaneous flap: a prospective study in 16 patients

Lv, Yang; Cao, Dong‐Sheng; Guo, Fangfang; Qian, Yunliang; Wang, Chen; Wang, Danru

doi:10.1016/j.amjsurg.2014.11.008

Cited by 22 publications

(18 citation statements)

References 46 publications

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“…However, mesh repair is contraindicated in infected abdominal wall defects. A number of studies have reported the repair of an abdominal wall defect using a fascia lata patch [3, 13, 14]. In the present case, we used a fascia lata free flap to close the pelvic floor defect.…”

Section: Discussionmentioning

confidence: 97%

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

Shinmoto¹,

Miyanari²,

Sugihara³

et al. 2017

surg case rep

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BackgroundFournier gangrene due to advanced rectal cancer is a rapidly progressive gangrene of the perineum and buttocks. Emergency surgical debridement of necrotic tissue is crucial, and secondary surgery to resect tumors is necessary for wound healing. However, pelvic exenteration damages the pelvic floor, increasing the likelihood of herniation of internal organs into the infectious wound. The management of pelvic exenteration for rectal cancer with Fournier gangrene has not yet been established. We herein describe the use of a fascia lata free flap in pelvic exenteration for rectal cancer with Fournier gangrene.Case presentationA 66-year-old male who had undergone colostomy for large bowel obstruction due to advanced rectal cancer and continued chemotherapy was referred to our hospital for Fournier gangrene resulting from chemotherapy. Emergency surgical debridement was performed, and the infectious wound around the rectal cancer was treated with intravenous antibiotic agents postoperatively. However, the tumor was exposed by the wound, and exudate persisted. Pelvic exenteration was performed due to tumor infiltration into the bladder and prostate. Tumor resection resulted in a defect in the pelvic floor. A fascia lata free flap (15 × 9 cm) obtained from the left thigh was fixed to the edge of the peritoneum and ileal conduit to close the defect in the pelvic floor and prevent small bowel herniation into the resected space. There was no intraabdominal inflammation or bowel obstruction postoperatively, and outpatient chemotherapy was continued.ConclusionsSurgical repair with a fascia lata free flap to close the defect in the pelvic floor led to a good clinical outcome for pelvic exenteration in a patient with Fournier gangrene due to advanced rectal cancer.

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Section: Discussionmentioning

confidence: 97%

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

Shinmoto¹,

Miyanari²,

Sugihara³

et al. 2017

surg case rep

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“…Hernia prevention is an important goal that must be achieved in abdominal reconstruction (Fukui, Fujioka, & Ishiyama, 2016). Hence, conventional methods have often used a combination of various types of synthetic meshes with local flaps mentioned above (Lv et al, 2015;Shih, 2018). Due to its simplicity and easy technique, it has been used widely.…”

Section: Resultsmentioning

confidence: 99%

Extensive full thickness abdominal wall reconstruction using anterolateral thigh compound flap modifications

Eun

2019

Microsurgery

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Purpose Abdominal wall reconstruction is challenging, which demands adequate skin coverage and structural support. The anterolateral thigh (ALT) flap including fascial portion can be useful in such cases. Methods Retrospective chart review of five patients that underwent complex abdominal wall defects reconstruction with ALT free flaps with fascia lata was conducted. Patient age ranged from 49 to 69 years (average: 57.4). The etiology of defects was infected liposuction site, small bowel perforation, esophageal cancer, diverticulum perforation, and Hartmann operation. The average size of the defect was 17.4 × 10 cm (9 × 9 ~ 21 × 18). Single‐stage reconstruction using ALT flaps based on the lateral circumflex femoral artery was done in all patients. Exposed intestines were successfully covered and reinforced utilizing fascial component. Results The average size of the flap was 17.4 × 8 cm (9 × 9 cm ~25 × 10 cm). One partial flap necrosis, venous congestion, and infection occurred. These complications were treated successfully. During the follow‐up (12–96 months, mean: 63), all patients achieved functional stabilization and returned to normal activities. Conclusion ALT flap combined with its fascial component is useful for abdominal wall. It can be a reliable option in cases of intestinal exposure.

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“…The vast majority of complex abdominal wall defects requiring microsurgical flap reconstruction resulted from primary or metastatic abdominal wall malignancies according to the literature review (Hahn, Lee, & Keith, ; Gurunluoglu, Ghaznavi, Krpata, Zins, & Rosen, ; Vallam, Bhagat, Shankhdhar, & Qureshi, ; Bodin et al, ; Lv et al, ; Steffensen, Thomassen, Jensen, & Soerensen, ; Fejjal et al, ; Iida et al, ; Kayano et al, ; Grinsell, Di Bella, & Choong, ; Sinna, Gianfermi, Benhaim, Qassemyar, & Robbe, ; Kadoch, Bodin, Himy, Bollecker, & Bruant‐Rodier, ; Tukiainen & Leppäniemi, ; Dorai & Halim, ; Servant, Arnault, Revol, & Danino, ; Kuo et al, ; Chevray & Singh, ; Kimata et al, ; Sasaki, Nozaki, Nakazawa, Kikuchi, & Huang, ; Ninković, Kronberger, Harpf, Rumer, & Anderl, ; Williams, Carlson, deChalain, Howell, & Coleman, ; Penington, Theile, MacLeod, & Morrison, )…”

Section: Discussionmentioning

confidence: 99%

Recipient vessels for microsurgical flaps to the abdomen: A systematic review

Gürünlüoğlu

Rosen

2017

Microsurgery

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Abdominal wall reconstruction using a combination of free tensor fasciae lata and anterolateral thigh myocutaneous flap: a prospective study in 16 patients

Cited by 22 publications

References 46 publications

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

Extensive full thickness abdominal wall reconstruction using anterolateral thigh compound flap modifications

Recipient vessels for microsurgical flaps to the abdomen: A systematic review

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