Use of the superior pedicled rectus abdominis flap to cover infected aortic grafts

Replacement of aortic aneurysms by a prosthetic graft is a common procedure in vascular surgery. Although success is generally achieved, infection or fistula may occur. Prosthetic graft infection has been reported in between one and six percent in most large series and is one of the most dreaded complications of abdominal aorta surgery. Dissatisfaction with extraanatomic procedures has led to the development of techniques of in situ replacement by allogenic material. However, adequate debridement and coverage of the aortic graft is necessary. To our knowledge, this is the first report of the use of a rectus abdominis muscle flap to cover an aortic allograft when other reconstructive options were impossible.