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01-12-2011 | How-I-Do-It Article

The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients

Authors: Adrien Daigeler, Maria Simidjiiska-Belyaeva, Daniel Drücke, Ole Goertz, Tobias Hirsch, Christian Soimaru, Marcus Lehnhardt, Hans-Ulrich Steinau

Published in: Langenbeck's Archives of Surgery | Issue 8/2011

Abstract

Purpose

The vertical rectus abdominis muscle (VRAM) flap is considered a safe and simple option to cover defects of the trunk and proximal thigh. Detailed long-time follow-up studies in oncologic patients including complications and donor site morbidity are rare. In this study, complications and donor site morbidity were analysed.

Methods

Data of 78 consecutive patients with oncologic disease, having received VRAM flaps, were analysed retrospectively. Patients with soft tissue sarcomas (n = 38), radiation ulcers (n = 18), carcinoma (n = 10), wound-healing difficulties after tumour resection (n = 8), breast reconstruction after ablation (n = 3) and malignant melanoma (n = 1) were included. Statistics concerning patients' satisfaction, the occurrence of wound-healing difficulties, incisional herniation, loss of abdominal wall strength in correlation to operative and (neo)adjuvant treatment and patients' history were performed. The mean follow-up time was 5.5 years.

Results

No complete flap loss was observed. A body mass index over 30 was positively correlated with wound-healing difficulties; radiation had no negative effect. A contralateral cutaneous pedicle could reduce the risk of lymphoedema in groin defect patients. Incisional hernia was present in 13%. Strength endurance of the abdominal wall was reduced compared to an age-matched control. Most patients were satisfied with the postoperative result.

Conclusions

VRAM flaps are reliable tools for defect coverage in the oncologic patient to prevent chronic ulceration, lymphangitis or more severe complications like septic rupture of femoral vessels and hip disarticulation. Donor site morbidity is tolerable, and patients' satisfaction is high.

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Title: The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients
Authors: Adrien Daigeler
Maria Simidjiiska-Belyaeva
Daniel Drücke
Ole Goertz
Tobias Hirsch
Christian Soimaru
Marcus Lehnhardt
Hans-Ulrich Steinau
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 8/2011
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-011-0823-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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