The rectus abdominis flap for perineal wounds

Area of Science:

• Surgical Oncology
• Plastic and Reconstructive Surgery

Background:

• Large perineal wounds often result from advanced malignancy excision or rectal excision combined with radiotherapy.
• Effective wound closure is critical for patient recovery and preventing complications.

Observation:

• An inferiorly based rectus abdominis myocutaneous flap, harvested through the pelvis, was utilized for reconstruction.
• This technique facilitated rapid healing in two out of three cases.

Findings:

• One case experienced flap loss due to delayed venous thrombosis, highlighting a potential complication.
• Histological examination revealed venous thrombosis as the cause of flap failure.

Implications:

• The study recommends preserving a portion of the rectus muscle below the inferior epigastric artery's entry point.
• This modification aims to prevent vascular kinking and reduce the risk of flap-related complications.