Abstract
Flap reconstruction of the abdominal wall is required when there is a tissue defect that exceeds the availability of local tissue to be recruited to resurface the defect. As the majority of abdominal wall defects can be reconstructed with the surrounding redundant tissue from the torso, these defects requiring flap coverage represent a more complex subset of abdominal wall reconstructions. Indications for flap coverage vary by etiology of defect, defect characteristics, and timeline for closure. Flap reconstruction can be performed with local flaps rotation, advancement keystone flaps from the remaining tissue of the trunk. Regional flaps can be harvested from the back or thigh and maintain a pedicled blood supply from the axilla or groin. Free-flap reconstructions represent the most technically challenging flap transfers as they require arteriovenous microanastomosis to revascularize the flap in the recipient site.
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Fortelny RH, Hofmann A, Gruber-Blum S, Petter-Puchner AH, Glaser KS. Delayed closure of open abdomen in septic patients is facilitated by combined negative pressure wound therapy and dynamic fascial suture. Surg Endosc. 2014;28(3):735–40.
Deeken CR, Eliason BJ, Pichert MD, Grant SA, Frisella MM, Matthews BD. Differentiation of biologic scaffold materials through physicomechanical, thermal, and enzymatic degradation techniques. Ann Surg. 2012;255(3):595–604.
Glass GE, Murphy GF, Esmaeili A, Lai LM, Nanchahal J. Systematic review of molecular mechanism of action of negative-pressure wound therapy. Br J Surg. 2014;101(13):1627–36.
Booth JH, Garvey PB, Baumann DP, Selber JC, Nguyen AT, Clemens MW, Liu J, Butler CE. Primary fascial closure with mesh reinforcement is superior to bridged mesh repair for abdominal wall reconstruction. J Am Coll Surg. 2013;217(6):999–1009.
Disa JJ, Goldberg NH, Carlton JM, Robertson BC, Slezak S. Restoring abdominal wall integrity in contaminated tissue-deficient wounds using autologous fascia grafts. Plast Reconstr Surg. 1998;101(4):979–86.
Khouri JS, Egeland BM, Daily SD, Harake MS, Kwon S, Neligan PC, Kuzon Jr WM. The keystone island flap: use in large defects of the trunk and extremities in soft-tissue reconstruction. Plast Reconstr Surg. 2011;127(3):1212–21.
Selber JC, Angel Soto-Miranda M, Liu J, Robb G. The survival curve: factors impacting the outcome of free flap take-backs. Plast Reconstr Surg. 2012;130(1):105–13.
Lin SJ, Butler CE. Subtotal thigh flap and bioprosthetic mesh reconstruction for large, composite abdominal wall defects. Plast Reconstr Surg. 2010;125(4):1146–56.
Selvaggi G, Levi DM, Cipriani R, Sgarzani R, Pinna AD, Tzakis AG. Abdominal wall transplantation: surgical and immunologic aspects. Transplant Proc. 2009;41(2):521–2.
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© 2016 Springer International Publishing Switzerland
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Baumann, D.P., Butler, C.E. (2016). Flap Reconstruction of the Abdominal Wall. In: Novitsky, Y. (eds) Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27470-6_30
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DOI: https://doi.org/10.1007/978-3-319-27470-6_30
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