Gunshot Abdominal Wall Injury Reconstructed with an Innervated Latissimus Dorsi Free Flap

Use of tissue expanders in the repair of complex abdominal wall defects

“…The reconstructive ladder is a term used by plastic surgeons to describe the approach to increasingly complex wounds, beginning with healing by secondary intention, then moving on to primary or delayed primary closure, skin grafting, tissue expansion, random pattern flaps, pedicled flaps, and, finally, free tissue flaps. As stated by Ferreira et al [7], "the goals of reconstruction are threefold: (1) restoration of the function and integrity of the musculofascial abdominal wall, (2) prevention of visceral eventration, (3) provision of dynamic muscle support. "…”

“…Various reconstructive methods have been described, including staged silo closure, skin flap closure [1], use of a prosthetic mesh bridge to span the fascial defect [2], tissue expansion [3], component separation [4][5][6], rotational flap [7], and free flap coverage [8]. We describe a technique that uses tissue expanders placed subcutaneously, intramuscularly, or intraabdominally to aid in the reconstruction of a variety of complex abdominal wall defects.…”

A Case of Pediatric Abdominal Wall Reconstruction

“…This technique provides restoration of the function and integrity of the musculofascial abdominal wall, prevention of visceral eventration, and provision of dynamic muscle support. 5 This technique has been described for closure of difficult pediatric organ transplant, omphalocele repair, and certain trauma cases, but it has not been reported within the war theater setting—a setting in which it may have great utilities. 6–8 …”

Reconstruction of infected abdominal wall defects using latissimus dorsi free flap

“…This results in a large defect which cannot be reconstructed using regional flaps or the component separation technique. Hence, many studies have suggested that free tissue transfer should be considered …”

“…Hence, many studies have suggested that free tissue transfer should be considered. [1][2][3][4][5][11][12][13][14][15][16] For ideal reconstruction of abdominal defects, the basic requirements include maintaining the functional and aesthetic integrity of the abdominal wall. In this respect, the anterolateral thigh flap is suitable and has distinct advantages since it can be harvested with thick tensor fascia lata which are incorporated into the rectus sheath, forming tight structure which prevents abdominal hernias from occurring after reconstruction.…”