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Updated: Aug 2, 2026
11:12
In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury
Published on: June 8, 2013
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VRAM flap for an above knee amputation stump
1Plastic Surgeon, Plastic Surgery & Burns Unit, Kenyatta National Hospital, P.O. Box 2572-00202, Nairobi, Kenya.
JPRAS Open
|March 12, 2020
Summary
The pedicled vertical rectus abdominis myocutaneous (VRAM) flap offers a viable solution for reconstructing above-knee amputation (AKA) stumps. This flap provides essential soft tissue coverage, potentially avoiding more extensive surgical procedures.
Area of Science:
- Reconstructive Surgery
- Plastic Surgery
- Trauma Surgery
Background:
- The pedicled vertical rectus abdominis myocutaneous (VRAM) flap is commonly used for groin, perineal, and thigh defects.
- Its application for above-knee amputation (AKA) stump coverage is rarely reported.
Observation:
- A 36-year-old male patient with a traumatic AKA stump secondary to an improvised explosive device (IED) injury underwent debridement.
- An ipsilateral pedicled VRAM flap was employed for soft tissue reconstruction of the AKA stump.
Findings:
- The VRAM flap successfully provided padded soft tissue coverage for the AKA stump.
- This approach preserved 6 cm of bone length below the greater trochanter.
- The procedure successfully avoided the need for a hip disarticulation or a free flap reconstruction.
Implications:
- The pedicled VRAM flap represents a valuable reconstructive option for complex AKA stumps.
- This technique can help maintain residual limb length and function, improving patient outcomes.
- Further investigation into the utility and considerations of VRAM flaps in AKA stump reconstruction is warranted.
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