Reconstruction of Abdominal Wall Defects Using a Pedicled Anterolateral Thigh Flap including the Vastus Lateralis Muscle: A Report of Two Cases

Abstract

The purpose of abdominal wall reconstruction is to prevent hernias and protect the abdominal viscera. In cases involving full-thickness defects of the rectus abdominis muscle, the muscle layer should be repaired. We present 2 cases in which full-thickness lower rectus abdominis muscle defects were reconstructed using vastus lateralis-anterolateral thigh flaps. The pedicled vastus lateralis-anterolateral thigh flap provides skin, fascia, and muscle tissue. Furthermore, it has a long neurovascular pedicle and can reach up to the periumbilical area and cover large defects. We consider that this muscle flap is a good option for repairing full-thickness lower abdominal defects.

Treatment of cervical cancer metastatic to the abdominal wall with reconstruction using a composite myocutaneous flap: A case report

“…It was used for skin reconstruction in several body parts, from the face to the trunk and the extremities (Zhou et al, 1991). The pedicled vastus lateralis-anterolateral thigh flap proved to be very useful in reconstructing abdominal wall defects with large muscle defect due to the long pedicle length, the large muscle volume of the flap, large vessel diameter and minor donor site morbidity and fast rehabilitation after surgery (Spyriounis and Lutz, 2008; Fukui et al, 2016). Passing the flap underneath the rectus femoris muscle will help achieve additional length of pedicle and cover a large abdominal defect (Tinj et al, 2010).…”

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

“…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).…”

Anterolateral thigh flap for abdominal wall reconstruction. A case report

“…Abdominal wall reconstruction using 2 free ALT flaps has been previously described [ 14 ]. A pedicled ALT flap can include a innervated portion of the vastus lateralis muscle and due to its long neurovascular pedicle, can reach the periumbilical region [ 15 ]. Regarding the free versus pedicled ALT flaps, there are no studies which report an increased rate of complications in pedicled group [ 15 ].…”

“…A pedicled ALT flap can include a innervated portion of the vastus lateralis muscle and due to its long neurovascular pedicle, can reach the periumbilical region [ 15 ]. Regarding the free versus pedicled ALT flaps, there are no studies which report an increased rate of complications in pedicled group [ 15 ]. Free flaps are usually used in supra-umblical defects or when the pedicle is not long enough [ 6 ].…”