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Tunnelled tensor fascia lata flap for complex abdominal wall reconstruction
Frederick Wang1, Samuel Buonocore, Deepak Narayan
1Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California-San Francisco, CA, USA.
BMJ Case Reports
|June 19, 2012
Summary
This study presents a novel technique using delayed tensor fascia lata (TFL) myofascial flaps for abdominal wall reconstruction in complex cases. The method achieved stable repairs, though seromas were noted at the donor sites.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Abdominal Wall Reconstruction
Background:
- Recurrent and infected abdominal wall defects pose significant reconstructive challenges.
- Traditional methods may have limitations in complex cases requiring robust tissue coverage and mesh integration.
Observation:
- Two patients with recurrent, infected abdominal wall defects were treated using bilateral delayed and tunnelled pedicled tensor fascia lata (TFL) myofascial flaps.
- In one case, Parietex Composite mesh was incorporated beneath the TFL flap prior to harvest.
- Cadaveric dissection identified anatomical variations, including the lateral femoral cutaneous nerve, relevant to TFL flap harvest.
Findings:
- Both patients achieved stable abdominal wall repairs using the described TFL flap technique.
- Donor site seromas requiring drainage were observed in both cases.
- The technique demonstrated successful tissue integration when mesh was used in conjunction with the TFL flap.
Implications:
- This modified TFL flap technique offers a viable option for complex abdominal wall reconstruction.
- Incorporating mesh prior to flap harvest may enhance reconstructive outcomes.
- Awareness of anatomical variations during TFL flap harvest is crucial for surgical safety and efficacy.
