Abdominal wall reconstruction with the free tensor fascia lata musculofasciocutaneous flap using intraperitoneal gastroepiploic recipient vessels.

Abstract

The authors report their experience with a method for definitive abdominal wall reconstruction using the free tensor fascia lata musculofasciocutaneous flap anastomosed to the intraperitoneal gastroepiploic vessels. This is a single-stage reconstruction capable of reconstructing reliably a full-thickness defect involving any region of the abdominal wall. The fascial component of the flap reconstructs the abdominal wall with like tissue, and the cutaneous portion of the free tensor fascia lata provides a durable and aesthetically acceptable external cover. The intraperitoneal gastroepiploic artery and vein were the first-choice recipient vessels used in all three patients. These intraperitoneal recipient vessels allow uninterrupted fascial closure, restoring structural integrity to the abdominal wall, and allow the use of free flaps with short vascular pedicles. The authors present a series of three cases of full-thickness upper and lower abdominal wall reconstruction using this method, presenting its advantages compared with other methods.