V-Y advancement of the inferiorly based rectus abdominis musculocutaneous flap

We describe two cases in which a rectus abdominis musculocutaneous flap was used to reconstruct an ipsilateral groin defect by V to Y advancement. Cadaveric studies undertaken to investigate the likely versatility of this flap showed that it may be advanced to midthigh level. This range can be increased by division of the inguinal ligament and by partial reflection of the rectus abdominis muscle from the skin island. The operative technique and the merits and disadvantages of the flap are discussed. This variation is a useful alternative. It has a considerable excursion potential and may be cosmetically more acceptable than other transposition flaps.