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Reconstruction of a Large Infected Midline Abdominal Wall Defect Using a Latissimus Dorsi Free Flap

  • Cha, Han Gyu (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Eun Key (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Suk-Kyung (Division of Trauma and Surgical Critical Care, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.07.05
  • Accepted : 2018.07.25
  • Published : 2018.08.31

Abstract

Managing large infected midline abdominal defects are clinically challenging and technically demanding. The alloplastic materials, regional flaps, and component separation are usually infeasible because of the size, location, depth, and state of the defects. In these cases, the free flap is the only option with a large well-vascularized tissue that is free to inset regardless of the location. Herein, we report a case of 44-year-old man with a large infected midline abdominal wall defect who was completely treated with a latissimus dorsi myocutaeous free flap followed by negative pressure wound therapy.

Keywords

References

  1. Calderon W, Chang N, Mathes SJ. Comparison of the effect of bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg 1986;77:785-94. https://doi.org/10.1097/00006534-198605000-00016
  2. Watson JS, Craig RD, Orton CI. The free latissimus dorsi myocutaneous flap. Plast Reconstr Surg 1979;64:299-305. https://doi.org/10.1097/00006534-197909000-00002
  3. Rohrich RJ, Lowe JB, Hackney FL, Bowman JL, Hobar PC. An algorithm for abdominal wall reconstruction. Plast Reconstr Surg 2000;105:202-16; quiz 217. https://doi.org/10.1097/00006534-200001000-00036
  4. Porshinsky B, Ramasastry S. Abdominal wall reconstruction with free flaps. Clin Plast Surg 2006;33:269-80. https://doi.org/10.1016/j.cps.2005.12.008
  5. Wong CH, Lin CH, Fu B, Fang JF. Reconstruction of complex abdominal wall defects with free flaps: indications and clinical outcome. Plast Reconstr Surg 2009;124:500-9. https://doi.org/10.1097/PRS.0b013e3181addb11
  6. Kuo YR, Yeh MC, Shih HS, Chen CC, Lin PY, Chiang YC, et al. Versatility of the anterolateral thigh flap with vascularized fascia lata for reconstruction of complex soft-tissue defects: clinical experience and functional assessment of the donor site. Plast Reconstr Surg 2009;124:171-80. https://doi.org/10.1097/PRS.0b013e3181a80594
  7. Gosain A, Chang N, Mathes S, Hunt TK, Vasconez L. A study of the relationship between blood flow and bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg 1990;86:1152-62; discussion 1163. https://doi.org/10.1097/00006534-199012000-00019
  8. Kim JT, Kim SW, Youn S, Kim YH. What is the ideal free flap for soft tissue reconstruction? A ten-year experience of microsurgical reconstruction using 334 latissimus dorsi flaps from a universal donor site. Ann Plast Surg 2015;75:49-54. https://doi.org/10.1097/SAP.0000000000000010
  9. Houston GC, Drew GS, Vazquez B, Given KS. The extended latissimus dorsi flap in repair of anterior abdominal wall defects. Plast Reconstr Surg 1988;81:917-24. https://doi.org/10.1097/00006534-198806000-00015
  10. DeFranzo AJ, Pitzer K, Molnar JA, Marks MW, Chang MC, Miller PR, et al. Vacuum-assisted closure for defects of the abdominal wall. Plast Reconstr Surg 2008;121:832-9. https://doi.org/10.1097/01.prs.0000299268.51008.47