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World Journal of Surgical Oncology

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Open Access 01-12-2019 | Rectal Cancer | Case report

AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient

Authors: Jan Matschke, Rafael Armbruster, Christian Reeps, Jürgen Weitz, Adrian Dragu

Published in: World Journal of Surgical Oncology | Issue 1/2019

Abstract

Background

The free flap transfer of a latissimus dorsi flap (LDF) for the closure of sacral wound defects after pelvic exenteration and radiation therapy offers a successful tool of the plastic surgeon. This case report shows the successful coverage using an upstream arterio-venous (AV) loop in combination with an LDF.

Case presentation

We describe the case of a patient who underwent a pelvic exenteration and radiation therapy due to a local recurrence of rectal cancer. The initially used VRAM flap could not ensure a satisfactorily wound closure. An interdisciplinary approach first yielded an AV loop using both greater saphenous veins and was connected to the arteria and vena femoris followed by a free LDF transfer, which was performed 11 days later. The result was an excellent reconstructive and plastic coverage of the sacral wound defect with a well-perfused LDF. The long-term result showed a perfectly integrated flap in the sacral region.

Conclusion

We recommend the free LDF for the coverage of large wound defects in irradiated areas after the failure of VRAM flap. If an AV loop is necessary within the flap transfer, we recommend conducting two procedures to guarantee the perfusion of the AV loop.

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Title: AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient
Authors: Jan Matschke
Rafael Armbruster
Christian Reeps
Jürgen Weitz
Adrian Dragu
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Rectal Cancer
Rectal Cancer
Published in: World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-019-1698-1

At a glance: The STEP trials

Springer Medicine

AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient

Abstract

Background

Case presentation

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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