Reconstructing abdominal wall defects with a free composite tissue flap: A case report.
1Department of Burn and Skin Repair Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou 570311, Hainan Province, China. wanggg23@hainmc.edu.cn.
World Journal of Clinical Cases
|March 17, 2021
Summary
Repairing large abdominal wall defects after electric burns is difficult. A combined anterolateral thigh and tensor fascia lata free flap successfully reconstructed the abdominal wall, restoring integrity and preventing hernia.
Area of Science:
- Reconstructive surgery
- Plastic surgery
- Burn treatment
Background:
- Huge full-thickness abdominal wall defects after debridement for electric burns present significant reconstructive challenges.
- Ideal abdominal wall repair necessitates restoring integrity, muscle tension, and preventing hernia formation.
- Composite autologous tissue flaps are a viable option for large full-thickness defects.
Observation:
- A 43-year-old male with extensive electric burns developed full-thickness abdominal wall defects, bowel necrosis, and duodenal leak.
- Initial management included debridement, bowel anastomosis, acellular dermal matrix grafting, and vacuum-assisted closure for temporary abdominal wall closure.
- A large 18 cm x 15 cm defect remained for definitive reconstruction.
Findings:
- The abdominal wall defect was successfully repaired using a combined anterolateral thigh and tensor fascia lata free flap.
- This reconstructive method achieved functional restoration of the abdominal wall.
- The repair restored integrity, maintained muscle tension, and prevented abdominal hernia formation.
Implications:
- This combined flap technique offers a viable solution for complex abdominal wall reconstruction post-burn.
- The approach leads to satisfactory aesthetic outcomes and avoids complications in the donor and recipient sites.
- Successful reconstruction prevents long-term morbidity associated with abdominal wall defects, such as hernia.
