New technical approach for the repair of an abdominal wall defect after a transverse rectus abdominis myocutaneous flap: a case report.

Journal of Medical Case Reports
Daniel A KaemmerVolker Schumpelick

Abstract

Breast reconstruction with autologous tissue transfer is now a standard operation, but abnormalities of the abdominal wall contour represent a complication which has led surgeons to invent techniques to minimize the morbidity of the donor site. We report the case of a woman who had bilateral transverse rectus abdominis myocutaneous flap (TRAM-flap) breast reconstruction. The surgery led to the patient developing an enormous abdominal bulge that caused her disability in terms of abdominal wall and bowel function, pain and contour. In the absence of rectus muscle, the large defect was repaired using a combination of the abdominal wall component separation technique of Ramirez et al and additional mesh augmentation with a lightweight, large-pore polypropylene mesh (Ultrapro). The procedure of Ramirez et al is helpful in achieving a tension-free closure of large defects in the anterior abdominal wall. The additional mesh augmentation allows reinforcement of the thinned lateral abdominal wall.

References

Jun 1, 1992·Plastic and Reconstructive Surgery·S S Kroll, M Marchi
Sep 1, 1990·Plastic and Reconstructive Surgery·O M RamirezA L Dellon
Feb 1, 1982·Plastic and Reconstructive Surgery·C R HartrampfP W Black
Jun 1, 1994·Plastic and Reconstructive Surgery·B J BaldwinB G Wang
Jul 1, 1997·British Journal of Plastic Surgery·N BlondeelG Matton
Jan 12, 2002·Plastic and Reconstructive Surgery·Maurice Y NahabedianPaul N Manson
Jul 9, 2002·Biomaterials·U KlingeV Schumpelick
May 26, 2004·Annals of Plastic Surgery·Aldo Benjamin GuerraRobert Johnson Allen
Jan 19, 2005·Annals of Plastic Surgery·Maurice Y Nahabedian, Bahram Momen
Sep 5, 2006·Langenbeck's Archives of Surgery·Joachim ConzeUwe Klinge

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