Abdominal wall reconstruction using a combination of free tensor fasciae lata and anterolateral thigh myocutaneous flap: a prospective study in 16 patients

• A surgeon must reconstruct the abdominal wall with sufficient strength to prevent incisional hernia or bulge, while avoiding postoperative intraperitoneal complications.
• Moreover, a plastic surgeon should not neglect esthetic aspects during this complex reconstructive surgery.
• Free TFL combined with ALT musculocutaneous flap provides both a large and strong fascial component and adequate coverage of the cutaneo-adipose layer.
• With a strong fascial layer, a dynamic reconstruction of the abdominal wall was presented.
• The TFL and ALT muscle can also improve the ability to resist infection.
• The patients were satisfied with the esthetic appearance of the abdominal wall.

BackgroundReconstruction of the abdominal wall continues to be a challenging problem for plastic surgeons. Transposition of well-vascularized flap tissue is the most effective way to repair composite abdominal wall defects. We retrospectively reviewed the treatment of such patients and assessed the reconstructive technique using combination of an inlay of bioprosthetic materials and a united thigh flap.MethodsA retrospective review of patients' records in the department was carried out. In total, 16 patients who underwent immediate abdominal wall reconstruction between 2000 and 2013 were identified. Patients' health status, defect sizes, and surgical technique were obtained from medical charts.ResultsThe immediate reconstruction surgery of the abdominal wall was successful in all patients. One patient with dermatofibrosarcoma protuberans experienced recurrences at the former site. One patient died because of liver metastases at 21 months after surgery. No incisional hernia or infection in this series of patients was observed.ConclusionFull-thickness, giant defects of the complicated abdominal wall can be repaired successfully with relatively minor complications using this reconstructive technique.