Donor site morbidity after rectus abdominis muscle flaps

Lutz, Barbara S.; Khawaja, Saud; Ingianni, G.

doi:10.1007/bf01152185

Cited by 10 publications

(5 citation statements)

References 45 publications

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“…The epidermis at the forearm is thinner than the epidermis at the thigh, which may match better the skin in the face, and the harvest of a suprafascial radial forearm flap takes between 30À40 min, whereas a superthin anterolateral thigh perforator flap takes approximately 90 min and more. The vertical myocutaneous rectus abdominis flap includes the risk of donor-site complications such as abdominal weakness, bulge, or hernia formation, 34 and a prolonged postoperative donor-site treatment regimen. In this series, the anterolateral thigh flap successfully replaced this flap.…”

Section: Discussionmentioning

confidence: 99%

Aesthetic and functional advantages of the anterolateral thigh flap in reconstruction of tumor‐related scalp defects

Lutz

2002

Microsurgery

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Eleven patients underwent free-flap reconstruction of tumor-related defects of the scalp, forehead, and temporal region. Flap selection aimed at achieving acceptable functional and aesthetic results combined with negligible donor-site morbidity. Ten males and one female, aged 61.3 +/- 14.3 years, were included in this study. Eight patients presented with tumor recurrences after previous surgery, irradiation, and/or chemotherapy. The average extension of defects was 169.5 (range, 30-600) qcm. Free flaps employed for reconstruction included antero-lateral thigh flaps (8), suprafascial radial forearm flap (1), lateral arm flap (1), latissimus dorsi muscle flap (1), and myocutaneous vertical rectus abdominis flap (1). Other procedures included nerve grafts to the facial nerve (2), ectropion correction (2), and fascia lata slings for static procedure in facial palsy (2). There was no pedicle revision and no flap failure. Donor-site morbidity was negligible. Hospitalization averaged 9.2 +/- 1.7 days. The anterolateral thigh perforator flap offers excellent coverage of tumor-related defects of the scalp, which require a thin flap for adequate contouring. The customized harvested myocutaneous anterolateral thigh flap is regarded as an elegant option for covering defects which consist of both deep and superficial areas. Fascia lata and nerve grafts are available at the same donor site. This easily allows additional procedures for cosmetic and functional improvement that are of high benefit for patients.

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Section: Discussionmentioning

confidence: 99%

Aesthetic and functional advantages of the anterolateral thigh flap in reconstruction of tumor‐related scalp defects

Lutz

2002

Microsurgery

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“…Most data refer to TRAM flaps and report herniation in 0-40% [2,24,29,38,40]. In VRAM flap patients, herniation or abdominal wall fascia dehiscence was reported in 9% [27], 12% [43] and 17% [6].…”

Section: Herniationmentioning

confidence: 98%

The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients

Daigeler

Simidjiiska‐Belyaeva

Drücke

et al. 2011

Langenbecks Arch Surg

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“…Additionally, with up to 90% of perineal resection in ELAPE being performed in the prone position [14], there is an additional requirement to turn the patient intraoperatively (60% of units preferring VRAM turned patients intraoperatively in our study). Other significant limitations of the VRAM flap include the risk of partial/total flap necrosis [12], significant donor site morbidity [25], and disruption of potential future stoma sites [24], the latter being an important consideration in younger patients who have a higher likelihood of developing parastomal hernia and need for stoma re-siting [26]. The use of the VRAM flap is limited in high body mass index patients, where flap raise and inset can be challenging due to the significant soft-tissue bulk.…”

Section: Discussionmentioning

confidence: 99%

A National Survey on Perineal Reconstruction Following Standard and Extralevator Abdominoperineal Excision: Current Practices and Trends in the UK

Shah¹,

Kamble²,

Herieka³

et al. 2022

Cureus

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BackgroundChallenging perineal defects resulting from extralevator (ELAPE) and standard abdominoperineal excision (APE) have given rise to an emerging multidisciplinary approach between colorectal and plastic surgeons. At present, there is a relative paucity of evidence on best practice. This study sought to assess current national practice concerning perineal reconstruction following APE/ELAPE in the United Kingdom (UK) and to determine the factors involved in reconstruction choice. MethodologyAn anonymised survey was circulated to consultant plastic surgeons at all 48 UK centres performing perineal reconstruction following APE/ELAPE. Responses were collected between October 2021 and April 2022. ResultsComplete responses were received from 24 units nationally. All units had a dedicated APE/ELAPE service. Overall, 70% adopted a standardised reconstructive approach, the most common being the inferior gluteal artery perforator flap (n = 11). Significant variation was identified in the reconstructive technique. Similar differences were observed in the perceived importance of surgical factors guiding the reconstructive decision-making process, the top priorities being the size of the defect and previous radiotherapy. ConclusionsThe variability of responses suggests a lack of national consensus on optimal reconstruction following APE/ELAPE, despite the majority of centres employing a standardised approach to reconstruction. Our study highlights important surgical decision-making factors and provides valuable insight to aid in developing national collaborative evidence-based guidelines on best practice.

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Donor site morbidity after rectus abdominis muscle flaps

Cited by 10 publications

References 45 publications

Aesthetic and functional advantages of the anterolateral thigh flap in reconstruction of tumor‐related scalp defects

Aesthetic and functional advantages of the anterolateral thigh flap in reconstruction of tumor‐related scalp defects

The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients

A National Survey on Perineal Reconstruction Following Standard and Extralevator Abdominoperineal Excision: Current Practices and Trends in the UK

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