Abstract:
Extensive abdominal wall defects requiring reconstruction with flaps are best done with
free flaps. However, free flaps are not readily available in many countries. Free flaps are associated with
long operative hours, technically demanding and are prone to complications. However, local or regional
flaps are a better option in managing such defects especially in resource-limited settings.
This was a prospective study to determine the outcome of patients with extensive abdominal
defects managed with local or regional flaps.
A total of fifteen patients with extensive abdominal wall defects were reconstructed with
local/regional flaps. Ten of these patients were managed with pedicle anterior lateral thigh flaps with two
tensor fascia lata flap and three para-umbilical abdominal flaps. The defect ranged from 90 to 300 cm 2
in size. All the flaps were successful, with only one patient experiencing flap dehiscence in a wound that
had sepsis. Donor site wounds in one patient had partial skin graft failure necessitating regular dressing
and repeat grafting later.
Local/regional flaps are reliable, good options for the management of majority of the ante-
rior abdominal wall defects, as they are less demanding, do not require long operative hours and are easy
to monitor post operatively. They should be considered in most reconstructive needs of the abdominal
wall.