Coverage of supraumbilical abdominal wall defects: The tunnelled‐pedicled ALT technique

Abstract

Abdominal wall defects are a challenge for reconstructive surgeons. Although the utility of anterolateral thigh perforator (ALT) flap has been well established for lower abdominal wall reconstruction, pedicled ALT flap is usually not considered for supraumbilical defects in the most recent algorithms. The purpose of this paper is to report the results of a tunneled pedicled ALT flap for reconstruction of supraumbilical defect from a series of patients. From July 2009 to September2014, six patients underwent delayed abdominal wall coverage using pedicled ALT flaps and reinforcement with polypropylene meshes. Defects occurred after surgical complications and abdominal trauma. Flaps were tunneled beneath the rectus femoris and sartorius muscles to increase the pedicle length. The size of the skin islands ranged from 22-29 × 10-14 cm. All flaps survived and the healing of the wounds was successful. Partial dehiscence of donor site occurred in one patient, and small wound dehiscence due to minimal distal necrosis was observed in another patient. No functional problems were reported in donor site, and no complications occurred in 6-68 months of follow-up. The tunneled pedicled ALT flap may provide a reliable alternative method for abdominal wall reconstruction, including supraumbilical defects. © 2015 Wiley Periodicals, Inc. Microsurgery 37:119-127, 2017.

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

“…The main advantages of using vascularized fascia lata in the reconstruction of the abdominal wall include a rapid recovery, high resistance to infection, and prevention of adhesion between the fascia surface and the intraperitoneal organs. (Fernandez-Alvarez et al, 2017) In this study, satisfactory results were obtained in two patients with abdominal wall defect using this fascia lata-ALT flap.…”

Abdominal Wall Reconstruction Using Pedicled Antero Lateral Thigh Flap

“…In the past few years, popularity of pedicled ALT flap has increased considerably. For abdominal wall reconstruction, the ALT flap has been successfully used 19 , 21 - 23 . Its vascular pedicle is long and reliable, and due to its versatility, flap can be designed accordingly to match the defect which requires reconstruction.…”

Free Versus Pedicled Anterolateral Thigh Flap for Abdominal Wall Reconstruction

“…Indeed, in hostile milieu, flaps can bring healthy vascularized tissue to the meshed area, offering a better antibiotic delivery and wound healing, in addition to obliterating the area (20,29). The ALT is the workhorse for soft-tissue reconstruction and has been successfully used for abdominal wall defects (22,25,30,31). Vranckx et al presented in 2015 the PIVA flap concept consisting of a pedicled ALT with an innervated vastus lateralis (20).…”