Vaginal reconstruction with the muscle-sparing vertical rectus abdominis myocutaneous flap

Rectus abdominis myocutaneous flaps for perineal reconstruction: modifications to the technique based on a large single-centre experience

“…Others have reported rates of between 0% and 11%. 12,[16][17][18] In our series we had a 19% incisional hernia rate, which is comparable with the literature. As all of these (3) occurred in our first eight patients, we have adopted the practice of reinforcing the donor site with mesh if it appears to be at risk of an incisional hernia due to patient size, build or being under tension at closure.…”

“…As all of these (3) occurred in our first eight patients, we have adopted the practice of reinforcing the donor site with mesh if it appears to be at risk of an incisional hernia due to patient size, build or being under tension at closure. Mesh was used by Weiwei et al in all five of their reported cases 18 and Petrie et al in 50% of their cases. 11 We experienced minor wound dehiscence in a few cases.…”

Reconstruction of complex groin defects with inferior epigastric artery-based rectus abdominis muscle flaps: report of two cases

“…[2] One of the most viable alternatives for the region is, therefore, a RAM flap with its abundant vascularity, more than adequate volume, and an arc of rotation long enough to ensure a tension-free closure. [1] A RAM flap harvested in an inferiorly based fashion, which depends on the inferior epigastric artery, may be used to address defects in the chest wall and lower abdominal, femoral, [11] vaginal, [12,13] penile, [11] ischial-trochanteric, [4] pelvic, [1,14] and sacral [15] regions. An inferiorly based RAM flap can either be harvested Reconstruction of complex groin defects with inferior epigastric artery-based rectus abdominis muscle flaps as a muscular unit only or with a skin paddle that may be planned as extended, oblique or vertical at the anterior abdomen.…”

An evolution of clinical application of inferior pedicle based rectus abdominis myocutaneous flap for repair of perineal defects after radical surgery for cancer

“…RAMF is now being also used for vaginal reconstruction in congenital absence of vagina. Weiwei et al 47 have modified VRAMF by muscle sparing, using only the skin island part for vaginal reconstruction in five patients of congenital absence of vagina. The recreated vagina was satisfactory and no complications occurred up to 2–9 moths follow‐up.…”

“…Since 1984, Inferior pedicle based RAMF is being increasingly used for repair of perineal defects of APR (Table I) 8, 10–31. New clinical indications and surgical modifications of inferior pedicle based RAMF have also been developed including repair of radical perineal vaginal defect (Table II) 32–42, repair of complex and extensive tissue loss due to benign conditions of perineum (Table III) 43–46 and reconstruction of congenital absence of vagina 47. The purpose of this review is to trace the evolutions of clinical use of inferior pedicle based RAMF and compile the available current information on its use in the perineum following APR and other clinical applications in the perineum.…”