Late necrosis of a pedicled rectus abdominis myocutaneous flap

Flap neovascularization is an important plastic surgery phenomenon, which allows the pedicle to achieve an alternative blood supply basis for pedicled flap autonomization. Numerous historical flaps have been described which provided the clinical evidence of its occurrence Neovascularization is assumed to happen between flap and recipient bed and numerous experimental and clinical studies have documented this phenomenon. There are, however, some literature reports of late flap failure due to lack of neovascularization. We present a case report that reinforces such findings, with a late rectus abdominis myocutaneous flap failure due to documented axial venous obstruction 4 months after inset.