Extended vertical rectus abdominis myocutaneous flap for reconstruction of large pelviperineal defects following oncologic resection

Autors de IIS La Fe

• Alberto Pérez García

  Autor

• Álvaro García-Granero García-Fuster

  Autor

• Alessandro Thione

  Autor

• 

  Matteo Frasson

  Autor

• Alberto Sanchez Garcia

  Autor

• Enrique Salmerón González

  Autor

• Santiago Domingo Del Pozo

  Autor

• Eduardo García-Granero Ximénez

  Autor

Autors aliens a IIS La Fe

• Simon, Eduardo

Grups d'Investigació

• Cirugía digestiva y Cuidados perioperatorios

  

  Leader

  Matteo Frasson

• Dermatología y Regeneración Tisular

  

  Leader

  Rafael Botella Estrada

• Medicina Reproductiva

  

  Investigador Principal

  José Morales Roselló

Abstract

Background and Objectives Extended vertical rectus abdominis myocutaneous (eVRAM) flap has been proposed for reconstruction of large pelviperineal defects where traditional VRAM flap is insufficient. We present our experience with eVRAM flap for pelviperineal reconstruction following oncologic resection. Methods A retrospective study was conducted, including all the patients who underwent reconstruction with eVRAM flap after complex pelvic resection, between 2012 and 2020. EVRAM flap was indicated when traditional VRAM was considered deficient to cover or reach the skin defect or to fill the dead space. Results Forty-four patients were included in the study. Successful reconstruction with eVRAM flap was achieved in 40 patients. There were three flap failures, and one patient died in the second postoperative day because of multiple organ failure. Perineal wound complications occurred in 17 patients (38.6%), eight of them requiring surgical reoperation. Donor site problems were present in five patients (11.4%), and only one patient required surgical closure because of a major dehiscence. Conclusions The authors found the eVRAM flap to be a useful and reliable flap for reconstruction of complex pelviperineal wounds, with a low rate of donor site morbidity.

© 2022 Wiley Periodicals LLC.

Keywords

• colorectal surgery; perineum surgery; rectus abdominis transplantation; wound healing