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Case Reports
. 2017 Jan 16:17:ic2.
eCollection 2017.

The Vertical Rectus Abdominis Musculocutaneous Flap As a Versatile and Viable Option for Perineal Reconstruction

Demetrius M Coombs  1 , Nirav B Patel  2 , Matthew R Zeiderman  2 , Michael S Wong  2
Affiliations
Case Reports

The Vertical Rectus Abdominis Musculocutaneous Flap As a Versatile and Viable Option for Perineal Reconstruction

Demetrius M Coombs et al. Eplasty. .
No abstract available

Keywords: VRAM; perineal reconstruction; radiation-induced tissue damage; squamous cell carcinoma; wound healing.

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Figures

Figure 1
Figure 1
Ulcerated right thigh lesion and persistent necrotizing soft-tissue infection upon presentation, despite multiple previous debridements (the patient in lithotomy).
Figure 2
Figure 2
Significant soft-tissue defect involving the right perineum and gluteal cleft following pelvic exenteration and abdominoperineal resection (in lithotomy; the top of photograph represents the patient's anterior perineum).
Figure 3
Figure 3
Immediately following right vertical rectus abdominis musculocutaneous flap inset and final closure (the patient in lithotomy; smaller photograph demonstrates elevation of the flap and the pedicle prior to rotation, inset, and closure).
Figure 4
Figure 4
Approximately 2.5 months postoperatively (note the evidence of wound healing delay evident near the posterior region of the flap). The right anterolateral perineum, a previously irradiated site unable to be approximated during the reconstruction, has contracted and granulated to the point of reepithelialization (the patient in the left lateral decubitus position; right side of the photograph demonstrates the patient's anterior perineum).
See this image and copyright information in PMC

References

    1. Hollenbeck ST, Toranto JD, Taylor BJ, et al. Perineal and lower extremity reconstruction. Plast Reconstr Surg. 2011;128(5):551e–63e. - PubMed
    1. Wong DS. Reconstruction of the perineum. Ann Plast Surg. 2014;73(suppl 1):S74–81. - PubMed
    1. Küntscher MV, Mansouri S, Noack N, Hartmann B. Versatility of vertical rectus abdominis musculocutaneous flaps. Microsurgery. 2006;26(5):363–9. - PubMed
    1. Nelson RA, Butler CE. Surgical outcomes of VRAM versus thigh flaps for immediate reconstruction of pelvic and perineal cancer resection defects. Plast Reconstr Surg. 2009;123(1):175–83. - PubMed
    1. Haubner F, Ohmann E, Pohl F, Strutz J, Gassner HG. Wound healing after radiation therapy: review of the literature. Radiat Oncol. 2012;7:162. - PMC - PubMed

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