Surgical outcomes of VRAM versus gracilis flaps for the reconstruction of pelvic defects following oncologic resection✰

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Michael J SteinMario Jarmuske

Abstract

Pelvic reconstruction following abdominoperineal resection or pelvic exenteration is associated with signification surgical site morbidity. Immediate pelvic reconstruction with a muscle flap is now the gold standard, associated with reduced perineal morbidity compared to primary closure alone.2,3 The purpose of the present study was to directly compare outcomes of VRAM and gracilis flap pelvic reconstruction following oncologic resection. A multicenter retrospective review was performed of 88 patients who underwent abdominoperineal resection or pelvic exenteration and immediate pelvic reconstruction, either with a VRAM (N = 61) or Gracilis flap (N = 27). Electronic medical records were analyzed for patient demographics, intraoperative data, and postoperative outcomes. Mortality, minor complication rate, major complication rate and time to complete wound healing was compared between groups. Overall, there was no significant difference in the minor complication rate (44% gracilis vs 48% VRAM, p = 0.8), major complication rate (19% gracilis vs 13% of VRAM, p = 0.53), 30-day mortality (0% VRAM vs 0% gracilis, p = 1.0) and median time to complete wound healing (68 days vs 67 days, p = 0.19) between the gracilis and VRAM groups. Musc...Continue Reading

Citations

May 23, 2020·Plastic and Reconstructive Surgery. Global Open·David PerraultArash Momeni
Aug 19, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S BankarA Saklani
Jan 19, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Matthew R ZeidermanLinda M Farkas
Dec 16, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Rami W RadwanMartyn D Evans
Jan 5, 2021·Diseases of the Colon and Rectum·Nishant Ganesh KumarTheodore A Kung
Apr 23, 2021·The American Surgeon·Olivia M DeLozierStephen W Behrman
Nov 24, 2021·Plastic and Reconstructive Surgery·Fara DayaniRahim S Nazerali

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