Experience with 80 rectus abdominis free-tissue transfers

Eighty patients receiving rectus abdominis free-tissue transfers are discussed. The operations were performed between July of 1983 and December of 1986. Specifically, the patients were followed in the clinic to determine the extent and degree of donor-site morbidity. Sixty-two flaps were transferred to the lower extremities, 15 to the head and neck, 2 to the arm, and 1 was placed intrathoracically. Osteomyelitis was the most common indication for free-muscle transfer in 33 patients, soft-tissue defects in 26, and facial soft-tissue augmentation in 14 patients. In the 80 rectus abdominis free-muscle transfers, there were 9 local complications. A seroma occurred in 4 patients, wound infection in 3, and an abdominal wall hernia occurred in 1 patient. The success rate for muscle transfer was 93 percent with six flap losses. Because there is a low incidence of donor-site complications, the surgical dissection is relatively easy, and the relative consistency and size of the deep inferior epigastric pedicle are good, the rectus abdominis muscular unit is now one of the most frequently used free-tissue transfers at our institution.