Local/regional flaps for extensive abdominal wall defects: Case series

Extensive abdominal wall defects requiring reconstruction with flaps are best done with free flaps. However, free flaps are not readily available in many countries. Free flaps are associated with long operative hours, technically demanding and are prone to complications. However, local or regional flaps are a better option in managing such defects especially in resource-limited settings.

This was a prospective study to determine the outcome of patients with extensive abdominal defects managed with local or regional flaps.

A total of fifteen patients with extensive abdominal wall defects were reconstructed with local/regional flaps. Ten of these patients were managed with pedicle anterior lateral thigh flaps with two tensor fascia lata flap and three para-umbilical abdominal flaps. The defect ranged from 90 to 300 cm² in size. All the flaps were successful, with only one patient experiencing flap dehiscence in a wound that had sepsis. Donor site wounds in one patient had partial skin graft failure necessitating regular dressing and repeat grafting later.

Local/regional flaps are reliable, good options for the management of majority of the anterior abdominal wall defects, as they are less demanding, do not require long operative hours and are easy to monitor post operatively. They should be considered in most reconstructive needs of the abdominal wall.