title: WITHDRAWN: The extended abdominal wall flap for transplantation.
abstract: BACKGROUND
  Patients with extensive loss of abdominal wall tissue have few options for restoring the abdominal cavity. Composite tissue allotransplantation has been used for limited abdominal wall reconstruction in the setting of visceral transplantation, yet replacement of the entire abdominal wall has not been described. The purpose of this study was to determine the maximal abdominal skin surface available through an external iliac/femoral cuff-based pedicle.
  
  
  METHODS
  Five human cadaver abdominal walls were injected with methylene blue to analyze skin perfusion based on either the deep inferior epigastric artery (DIEA; n = 5) or a cuff of external iliac/femoral artery (n = 5) containing the deep circumflex iliac, deep inferior epigastric, superficial inferior epigastric, and the superficial circumflex iliac arteries.
  
  
  RESULTS
  Abdominal wall flaps were taken full thickness from the costal margin to the mid-axial line and down to the pubic tubercle and proximal thigh. In all specimens, the deep inferior epigastric, deep circumflex iliac, superficial inferior epigastric, and the superficial circumflex iliac arteries were found to originate within a 4-cm cuff of the external iliac/femoral artery. Abdominal wall flaps injected through a unilateral external iliac/femoral segment had a significantly greater degree of total flap perfusion than those injected through the DIEA alone (76.5 +/- 4% versus 57.2 +/- 5%; Student t test, P < .05).
  
  
  CONCLUSIONS
  Perfusion of a large portion of the abdominal wall is possible using single-vessel anastomosis through a short segment of the external iliac/femoral system. Perfusion is significantly greater than that based on the DIEA vessel alone.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC.
authors.forename: S T
authors.initials: ST
authors.lastname: Hollenbeck
authors.forename: A
authors.initials: A
authors.lastname: Senghaas
authors.forename: R
authors.initials: R
authors.lastname: Turley
authors.forename: K V
authors.initials: KV
authors.lastname: Ravindra
authors.forename: M R
authors.initials: MR
authors.lastname: Zenn
authors.forename: L S
authors.initials: LS
authors.lastname: Levin
authors.forename: D
authors.initials: D
authors.lastname: Erdmann