Transretroperitoneal Pedicled Omental Flap for Coverage of Traumatic Sacral Defect: A Case Report

Area of Science:

• Reconstructive surgery
• Surgical anatomy
• Tissue engineering

Background:

• The greater omentum is a well-established option for soft-tissue reconstruction due to its consistent anatomy and vascularity.
• Its rich lymphatic tissue offers inherent resistance to infection, making it suitable for contaminated or compromised wound environments.
• Salvage reconstructive options are crucial for complex defects where standard techniques may fail.

Observation:

• A 46-year-old male patient presented with a complex traumatic sacral wound.
• The sacral wound presented significant challenges, severely limiting conventional reconstructive choices.
• A pedicled greater omentum flap was chosen as a salvage procedure.

Findings:

• The greater omentum flap was successfully transposed through the retroperitoneum.
• The flap utilized the lumbosacral triangle for access.
• Durable soft-tissue coverage was achieved for the sacral defect.

Implications:

• This case highlights the utility of the pedicled greater omentum flap in complex salvage scenarios.
• Transposition via the lumbosacral triangle provides a viable route for omental flap reconstruction in sacral defects.
• The greater omentum flap serves as a robust option for achieving functional and durable coverage in challenging reconstructive situations.