Saudi Journal of Medical and Pharmaceutical Sciences (SJMPS)
Volume-4 | Issue-01 | 24-27
Case Report
Surgical Management of Abdominal Wall Defect Using a Two-Stage Latissimus Dorsi Free Flap: A Case Report
Mohamed Amine Ennouhi, Alae Guerrouani, Abdennacer Moussaoui
Published : Jan. 30, 2018
Abstract
Managing abdominal wall tumors with high risk of relapse usually requires large excisions. It is the case of sarcomas, desmoid fibromatosis and abdominal wall metastases. The repair of large full-thickness defects of the abdominal wall usually needs the combination of a prosthetic material as a replacement of the deep layer and a reliable flap to cover the prosthetic material. Depending on the local condition of the surgical site and the size of the defect, the use of a free flap might become necessary. The authors report the case of a 55 year-old patient who underwent surgery for a relapsing sarcoma of the anterior abdominal wall. A two-stage reconstruction of the abdominal wall defect was performed using a free transfer of a myocutaneous Latissimus Dorsi flap. The first stage of reconstruction took place before the excision was performed. The free flap was then folded in the fashion of an “apple turnover” waiting for the second stage to take place, so the excision of the tumor and the final covering could be performed at the same surgical time. Microsurgical transfers imply potential peroperative and postoperative risks, especially the risk of vascular thrombosis. The authors discuss the two-stage surgical transfer of the myocutaneous Latissimus Dorsi free flap, its technique, its advantages and its disadvantages