Reconstruction of infected abdominal wall defects using latissimus dorsi free flap

Abstract

Reconstruction using the latissimus dorsi myocutaneous flap, including muscle fascia structures, is a potential treatment option for severely infected large abdominal wall defects.

Recipient vessels for microsurgical flaps to the abdomen: A systematic review

“…The other causes included hernia (Berrevoet, Martens, Van Landuyt, & de Hemptinne, ; Ninković, Kronberger, Harpf, Rumer, & Anderl, ; Caffee, ), abdominal trauma (Hallock, ; Wong, Lin, Fu, & Fang, ; Servant, Arnault, Revol, & Danino, ; Kuo et al, ), infection (Gurunluoglu, Ghaznavi, Krpata, Zins, & Rosen, ; Deleyiannis Harry Deleyiannis & Harry, 2014; Kim et al, ; Hallock, ; Bulic, Dzepina, Mijatovic, & Unusic, ; Ninković, Kronberger, Harpf, Rumer, & Anderl, ; Sekido, Yamamoto, Sugihara, Nohira, & Shintomi, ; Chiu, ), and previous multiple abdominal surgeries (Koshima et al, ; Williams, Carlson, deChalain, Howell, & Coleman, ; Clement, Young, & Marsh, ). Congenital reasons (Hallock, ; Olvera‐Caballero & Victoria‐Morales, ) and radiation (Gurunluoglu, Ghaznavi, Krpata, Zins, & Rosen, ; Hallock, ; Penington, Theile, MacLeod, & Morrison, ; Clement, Young, & Marsh, ) have been rare indications.…”

“…The literature review showed that the latissimus dorsi (Bodin et al, ; Steffensen, Thomassen, Jensen, & Soerensen, ; Fejjal et al, ; Kim et al, ; Kadoch, Bodin, Himy, Bollecker, & Bruant‐Rodier, ; Bulic, Dzepina, Mijatovic, & Unusic, ; Servant, Arnault, Revol, & Danino, ; Ninković, Kronberger, Harpf, Rumer, & Anderl, ; Olvera‐Caballero & Victoria‐Morales, ; Neven, Shepherd, Tham, Fisher, & Breach, ; Clement, Young, & Marsh, ), tensor fascia latae (Grinsell, Di Bella, & Choong, ; Wong, Lin, Fu, & Fang, ; Tukiainen & Leppäniemi, ; Dorai & Halim, ; Chevray & Singh, ; Lyle, Gibbs, & Howdieshell, ; Williams, Carlson, deChalain, Howell, & Coleman, ; Penington, Theile, MacLeod, & Morrison, ; Sekido, Yamamoto, Sugihara, Nohira, & Shintomi, ; Chiu, ; Caffee, ), and the anterolateral thigh flap (Hahn, Lee, & Keith, ; Gurunluoglu, Ghaznavi, Krpata, Zins, & Rosen, ; Vallam, Bhagat, Shankhdhar, & Qureshi, ; Hallock, ; Kayano et al, ; Sinna, Gianfermi, Benhaim, Qassemyar, & Robbe, ; Berrevoet, Martens, Van Landuyt, & de Hemptinne, ; Wong, Lin, Fu, & Fang, ; Kuo et al, ; Kimata et al, ) either single or in combination (Lv et al, ; Wong, Lin, Fu, & Fang, ; Kimata et al, ; Sasaki, Nozaki, Nakazawa, Kikuchi, & Huang, ) have been useful and reliable microsurgical flaps comprising the majority of free tissue transfers in abdominal wall reconstruction. Conjoined flaps incorporating vastus lateralis and anterolateral thigh flap (Iida et al, ), or rectus femoris (Lin & Butler, ), or tensor fascia latae (Lin & Butler, ), were rarely employed.…”

“…The most popular recipient vessels utilized have been the inferior epigastric in most reports (Vallam, Bhagat, Shankhdhar, & Qureshi, ; Bodin et al, ; Steffensen, Thomassen, Jensen, & Soerensen, ; Iida et al, ; Kim et al, ; Kayano et al, ; Kadoch, Bodin, Himy, Bollecker, & Bruant‐Rodier, ; Tukiainen & Leppäniemi, ; Dorai & Halim, ; Kuo et al, ; Kimata et al, ; Lyle, Gibbs, & Howdieshell, ; Ninković, Kronberger, Harpf, Rumer, & Anderl, ; Caffee, ) (Table ). The inferior epigastric (IE) vessels have been the preferred vessels because of their close proximity and size (Strauch, Yu, Chen, & Liebling, ) (Table ).…”

“…Literature review showed that the internal thoracic vessels (IT) have also been used though much less frequently to directly supply a microsurgical flap to the abdomen (Lv et al, ; Kim et al, ; Berrevoet, Martens, Van Landuyt, & de Hemptinne, ). These vessels can be dissected as previously described in a number of articles, most frequently at the 3rd or 4th intercostal space.…”

“…Preoperative Doppler imaging is useful to determine suitability of these vessels (Schwabegger, Bodner, Rieger, Jaschke, & Ninković, ). Because of their cranial location in relation to the abdomen, these vessels are more commonly preferred for microsurgical flaps to the upper and/or mid abdominal defects (Lv et al, ; Kim et al, ; Berrevoet, Martens, Van Landuyt, & de Hemptinne, ). The decision to use the IT or IE vessels should be based upon their availability, the size, and location of the abdominal wall defect, type of free flap, and its pedicle length.…”