Philippine Journal of Surgical Specialties Vol. 72, No. 2, July-December, 2017, pp 50-56

Abdominal Wall Reconstruction Using an Anterolateral Thigh Free Flap for a Large Abdominal Wall Defect

Author(s): Alexandra Monica L. Tan, MD, Eric Perpetuo E. Arcilla, MD, FPAPRAS, FPCS and Richard D.L. Quing, MD

Abstract:

Objective:
To present a complicated case of abdominal wall reconstruction after tumor extirpation using an anterolateral thigh free flap. Methods: This is a report of a case managed at the Philippine General Hospital last September 2016.

Results:
A 25-year-old male, diagnosed case of recurrent colon adenocarcinoma, underwent wide excision of recurrent abdominal wall tumor with fistula, resulting to 15cm x 30cm full thickness soft tissue abdominal wall defect with exposed bowels. A free anterolateral thigh fasciocutaneous flap was designed and elevated to cover the abdominal wall defect. Recipient vessels (contralateral deep inferior epigastric artery and veins) were anastomosed with donor vessels (descending branch of lateral circumflex femoral artery and veins). The donor site was closed with split thickness skin grafting.

Conclusion:
The free anterolateral thigh flap allows for coverage of complicated recurrent abdominal wall malignancies, allowing for a single-stage surgery, with little donor site morbidity and shorter hospital stay.

Key words: free tissue transfer flap, microsurgical free flap