[The greater omentum. Its role in reconstructive plastic surgery]

Area of Science:

• Surgical Reconstruction
• Tissue Engineering
• Microsurgery

Context:

• The greater omentum, a visceral flap, possesses unique properties beneficial for complex defect repair.
• Recent research has elucidated its physiological roles in defense, detersion, and revascularization.
• Surgical approaches utilize gastro-omental pedicles for flap design and transfer.

Purpose:

• To review the reconstructive potential and current indications for using the greater omentum as a surgical flap.
• To highlight the omentum's specific properties and surgical applications in complex cases.
• To delineate the limitations and contraindications for omentoplasty.

Summary:

• The greater omentum serves as a robust flap for complex reconstructive surgery, particularly in cases where other methods are insufficient.
• Its flap can be transferred pedicled or as a free graft, revascularized by microsurgery, and is indicated for infected, radiated, or deep defects.
• Specific applications include oropharyngeal cancer reconstruction, trauma involving significant tissue loss, and thoracic empyema management.

Impact:

• Omentoplasty remains an invaluable technique for challenging reconstructive scenarios, offering a reliable solution for tissue defects.
• The greater omentum's unique biological properties facilitate healing and tissue regeneration in compromised surgical sites.
• This flap provides a critical option for limb salvage and reconstruction in severe trauma and complex oncological resections.