Use of the omentum flap as additional soft-tissue cover for abdominal wall defects reconstructed with Gore-Tex.
BACKGROUND
Use of alloplastic materials such as Gore-Tex and locoregional flaps for reconstruction of large abdominal wall defects has been well described. The purpose of this article is to present a novel technique of using the omentum as an interpositional flap to protect the Gore-Tex repair of the abdominal wall.


METHODS
Four patients with large abdominal wall defects underwent reconstruction with Gore-Tex and omentum flap. These defects resulted from tumor resection and recurrent incisional hernia. Their dimensions ranged from 15 x 10 cm to 25 x 27 cm. The Gore-Tex patch was inset using an underlay technique. The omentum was tunneled through a separate opening in the abdominal wall into the subcutaneous plane and used to cover the Gore-Tex. Skin coverage was accomplished by direct closure or myocutaneous flaps.


RESULTS
The mean follow-up was 17 months. All wounds healed, with no hernias. One patient developed a subcutaneous abscess 6 months postoperatively, and this was treated successfully by percutaneous drainage, as the omentum had walled-off the abscess.


CONCLUSIONS
The omentum flap served as an additional soft-tissue cover over the Gore-Tex repair to prevent exposure in the event of infection or flap breakdown. This technique is useful in situations in which delayed wound healing is anticipated or when large quantities of prosthetic material are used.
Wong
Chin-Ho
CH
Department of Plastic Surgery, Singapore General Hospital, Singapore.
Tan
Bien-Keem
BK
Koong
Heng-Nung
HN
Lim
Chong-Hee
CH
Chia
Sing-Joo
SJ
Song
Colin
C
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery; D006801:Humans; D008297:Male; D019042:Muscle Neoplasms / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009852:Omentum; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D019736:Prostheses and Implants; D016459:Prosthesis-Related Infections / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012509:Sarcoma / Q000601:surgery; D013524:Surgical Flaps; D014945:Wound Healing
D011138:Polytetrafluoroethylene