scholarly journals Reconstruction of Abdominal Wall Defects Using a Pedicled Anterolateral Thigh Flap including the Vastus Lateralis Muscle: A Report of Two Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Kiyoko Fukui ◽  
Masaki Fujioka ◽  
Satoko Ishiyama
Keyword(s):  
Abdominal Wall ◽  
Vastus Lateralis ◽  
Abdominal Wall Reconstruction ◽  
Rectus Abdominis ◽  
Anterolateral Thigh Flap ◽  
Vastus Lateralis Muscle ◽  
Abdominal Wall Defects ◽  
Full Thickness ◽  
Rectus Abdominis Muscle ◽  
Anterolateral Thigh

The purpose of abdominal wall reconstruction is to prevent hernias and protect the abdominal viscera. In cases involving full-thickness defects of the rectus abdominis muscle, the muscle layer should be repaired. We present 2 cases in which full-thickness lower rectus abdominis muscle defects were reconstructed using vastus lateralis-anterolateral thigh flaps. The pedicled vastus lateralis-anterolateral thigh flap provides skin, fascia, and muscle tissue. Furthermore, it has a long neurovascular pedicle and can reach up to the periumbilical area and cover large defects. We consider that this muscle flap is a good option for repairing full-thickness lower abdominal defects.

scholarly journals Innervated Free Flap Abdominal Wall Reconstruction: A Systematic Review

2017 ◽  
Vol 02 (02) ◽  
pp. e118-e123
Author(s):  
Paul Therattil ◽  
Stephen Viviano ◽  
Edward Lee ◽  
Jonathan Keith
Keyword(s):  
Abdominal Wall ◽  
Free Flap ◽  
Vastus Lateralis ◽  
Abdominal Wall Reconstruction ◽  
Free Flaps ◽  
Fascia Lata ◽  
Sensory Innervation ◽  
Abdominal Wall Defects ◽  
Tensor Fascia Lata ◽  
Anterolateral Thigh

Background Reconstruction of large abdominal wall defects provides unique challenges to the plastic surgeon. Reconstruction with innervated free flaps has been described and allows for true functional replacement of “like with like.” The authors sought to determine the frequency and outcomes of such reconstructions. Methods A literature review was performed using MEDLINE (PubMed), EMBASE, and the Cochrane Collaboration Library for research articles related to innervated free flaps in abdominal wall reconstruction. Results Nine case series (16 patients) were included who underwent free flap reconstruction of the abdominal wall with motor and/or sensory innervation. Reconstruction was performed with latissimus dorsi (n = 5), tensor fascia lata (n = 4), rectus femoris (n = 2), combined tensor fascia lata-anterolateral thigh (n = 2), combined vastus lateralis-tensor fascia lata-anterolateral thigh flaps (n = 2), and vastus lateralis-anterolateral thigh (n = 1). All but one reconstruction had motor neurotization performed (n = 15), while only 12.5% (n = 2) had sensory neurotization performed. At least 66.6% of patients (n = 10) who had motor neurotization regained motor function as evidenced by documented clinical examination findings while 93.3% (n = 14) had “satisfactory” motor function on author's subjective description of the function. Both flaps that had sensory innervation were successful with Semmes–Weinstein testing of 3.61. Conclusion A majority of neurotized free flap reconstructions for abdominal wall defects have been performed for motor innervation, which is almost invariably successful. Sensory neurotization has been carried out for a small number of these reconstructions, and also has been successful. Improvements in techniques and outcomes in innervated free flap abdominal wall reconstruction are important to advancing efforts in abdominal wall transplantation.

scholarly journals 1024 The Use of the Pedicled Anterolateral Thigh (ALT) Flap for the Reconstruction of Abdominal Wall Defects in High-Risk Patients: A Case Series and Systematic Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Newall ◽  
C Jones ◽  
W Ho ◽  
A Curnier
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Case Series ◽  
Anterolateral Thigh Flap ◽  
Abdominal Wall Defects ◽  
High Risk Patients ◽  
Anterolateral Thigh ◽  
Risk Patients

Abstract Introduction The pedicled anterolateral thigh (ALT) flap is considered as a suitable option in complex abdominal wall reconstruction. Its use as a reconstructive option is infrequent in the literature, and to date, there has been no systematic review evaluating its long-term outcomes. We report our experience with the pedicled anterolateral thigh flap for abdominal wall reconstruction in high-risk patients. Method A prospective database was created for patients with abdominal wall defects treated with pedicled ALT with extended fascia lata flaps between 2014 and 2017. Patient demographics, aetiology, size, location of defect and post-operative results were reviewed. Abdominal defects were classified into the following zones: 1A, upper midline; 1B, lower midline; 2, upper quadrant; 3, lower quadrant. A systematic review of the literature was conducted using PUBMED and EMBASE. Results 4 patients (mean age 59.5 years, range 50-65 years) underwent reconstruction with pedicled ALT flaps. 3 flaps developed partial necrosis secondary to infection; 1 flap required surgical debridement, and 2 were managed conservatively. There was one flap failure, due to avulsion of the pedicle during inset. At mean follow up of 2.75 years (range 1 to 4 years) 3 patients have clinical bulging or herniation. Conclusions Review of the literature demonstrated 52 patients from 17 case series or reports. The overall infection and partial flap loss rates were both 6%. There were no reported flap failures. Our study demonstrates that the pedicled anterolateral thigh flap is an effective flap option for the repair of large defects of the abdominal wall in high-risk patients.

scholarly journals Free Versus Pedicled Anterolateral Thigh Flap for Abdominal Wall Reconstruction

2019 ◽  
Vol 39 (12) ◽  
pp. 6759-6768
Author(s):  
PIETRO G. DI SUMMA ◽  
WILLIAM WATFA ◽  
CORRADO CAMPISI ◽  
SALVATORE GIORDANO ◽  
CARLO M. ORANGES ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Anterolateral Thigh Flap ◽  
Anterolateral Thigh

Anterolateral Thigh Flap for Abdominal Wall Reconstruction

1999 ◽  
Vol 103 (4) ◽  
pp. 1191-1197 ◽  
Author(s):  
Yoshihiro Kimata ◽  
Kiyotaka Uchiyama ◽  
Mitsuru Sekido ◽  
Minoru Sakuraba ◽  
Hideo Iida ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Anterolateral Thigh Flap ◽  
Anterolateral Thigh
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