Feasibility of pedicled anterolateral thigh flap with tensor fascia lata and vastus lateralis for difficult abdominal wall closure

Shih, Pin‐Keng

doi:10.1007/s10029-018-1859-0

Cited by 16 publications

(11 citation statements)

References 15 publications

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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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Section: Resultsmentioning

confidence: 99%

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

Eun

2019

Microsurgery

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“…Partition technique and component technique are general methods for midline fascia closure even if it was contaminated. However, partition technique has a high complication rate of 50%, especially when a defect width is larger than 11.35 cm (Shih, 2019). Component separation has a relatively lower complication rate of 13%, but can hardly be applied in a large defect case (Shih, 2015; Shih, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal wall reconstruction with active infection is challenging, in which a contaminated wound can cause a high risk of sepsis and recurrence of herniation (Hodkinson, Maeda, Leo, Warusavitarne, & Vaizey, 2017). To reconstruct the abdominal wall, components separation is commonly performed, which allows abdominal wall reconstruction around the umbilicus level with approximately 10 cm fascial defect (Shih, 2019). For large lower abdominal wall reconstruction especially in active infection cases, pedicled tensor fascia lata (TFL) flap is preferably used to reconstruct the abdominal wall defect with a vascularized flap against the infection (Martis, Rózsahegyi, Deák, & Damjanovich, 2017).…”

Section: Introductionmentioning

confidence: 99%

Free superficial circumflex iliac artery perforator fascial flap for reconstruction of upper abdominal wall with extensive infected herniation: A case report

et al. 2020

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Complex abdominal wall reconstruction is challenging, and vascularized fascia is preferred for active infection cases. Pedicled tensor fascia lata flap is commonly used for lower abdominal wall reconstruction, and free vascularized fascial flap based on the lateral circumflex femoral artery (LCFA) is used for upper abdominal wall reconstruction. However, LCFA‐based flap transfer requires invasive and time‐consuming muscle dissection and a large recipient vessel. The purpose of this report was to present a new application of superficial circumflex iliac artery (SCIA) perforator (SCIP)‐based fascial flap for upper abdominal wall reconstruction. A 70‐year‐old male suffered from a long‐lasting extensive abdominal wall herniation complicated with mesh infection and cutaneous fistulae following multiple herniation repair with synthetic mesh. After complete debridement of infected tissues, there was a 29 x 26 cm full‐thickness abdominal wall defect. Components separation was performed to minimize the defect size, after which 12 x 7 cm defect remained in the upper abdominal wall. A 20 x 10 cm SCIP deep fascial flap was elevated based on the deep branch of the SCIA. The SCIP flap was transferred to the defect to reconstruct the upper abdominal wall. The SCIP was anastomosed to the deep inferior epigastric artery perforator with supermicrosurgical perforator‐to‐perforator anastomosis. Postoperative course was uneventful with good functional and esthetic results of the donor and recipient sites 11 months after the surgery. Although further studies are required, SCIP fascial flap may be an option for upper abdominal wall reconstruction.

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“…In tissue engineering and regenerative medicine, biomaterials are considered superior to synthetic materials for the repair of abdominal wall defects, owing to their ability to minimize adhesion formation, provide a better framework for fibroblast proliferation, and neovascularization. Recent researches reported that several biomaterials have been used for the abdominal wall defects, such as small intestine mucosa, 8 tensor fascia lata and lattisimus dorsi muscle, 9 autologous full-thickness skin and dermis, 10 porcine dermal collagen, 11 etc. However, these biomaterials still have limitations for abdominal wall regeneration, such as inflammatory oedema, mechanical strength, adhesion formation, formability, and recurrence.…”

Section: Introductionmentioning

confidence: 99%

A facile strategy for fabricating composite patch scaffold by using porcine acellular dermal matrix and gelatin for the reconstruction of abdominal wall defects

Liu

Zhang

et al. 2020

J Biomater Appl

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Defects of the abdominal wall continue to be a significant issue in regenerative medicine and tissue engineering. Porcine acellular dermal matrix (P-ADM) and gelatin have been widely used for fabricating engineered abdominal wall due to their good biocompatibility and integration with host tissues. In this study, we demonstrate a novel and reproducible approach of using gelatin and P-ADM powder to fabricate composite patch scaffolds by combining solvent casting and enzymatic cross-linking for the abdominal wall regeneration in rats. Different concentration ratios of gelatin and P-ADM and different shapes of engineered scaffolds are studied for various abdominal wall defects. Skeletal muscle cells and human umbilical vein endothelial cells can successfully attach to the surface of the scaffolds and maintain high viability after culturing for five days. In vivo experiments demonstrate that there are no signs of infection, intra-abdominal adhesion, and severe inflammation after two weeks, which indicate good repairability of the scaffolds. In conclusion, we propose a novel method that holds great potential for building engineered scaffolds to meet the different requirements of abdominal wall regeneration.

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Feasibility of pedicled anterolateral thigh flap with tensor fascia lata and vastus lateralis for difficult abdominal wall closure

Cited by 16 publications

References 15 publications

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

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

Free superficial circumflex iliac artery perforator fascial flap for reconstruction of upper abdominal wall with extensive infected herniation: A case report

A facile strategy for fabricating composite patch scaffold by using porcine acellular dermal matrix and gelatin for the reconstruction of abdominal wall defects

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