[Microvascular architecture of the all-layer free inferior abdominal wall flap]

The authors dissected all layers of the inferior abdominal wall to study the possibility of free transplantation to close combined skin and mucosal defects. They perfused these flaps with a special solution of lead oxide and gelatin (Rees and Taylor 1986). After fixation in formalin the flaps were dissected in their layers and radiographs of these were taken. Networks of small vessels, which originate in the inferior epigastric artery, were found preperitoneally in the deepest compartment, in the muscular compartment and, nourished by perforators via the ventral rectus fascia, epifascially and subdermally in the subcutaneous tissue. On this basis free microvascular transplantation of a full-thickness abdominal wall flap seems to be possible to close combined mucosal and cutaneous defects. To thin this flap the subcutaneous middle third could be removed taking care to protect the epifascial and subdermal plexus of vessels. An isolated pre- and peritoneal microvascular flap also seems to be possible.