title: Pedicled omental and split skin graft in the reconstruction of the anterior abdominal wall.
abstract: BACKGROUND
  The POSSG is a pedicled graft based on either the right or left gastro-epiploic arteries. It is used with a dual mesh in reconstruction of full thickness defects of anterior abdominal wall and covered by skin grafts.
  
  
  METHODS
  A recurrent malignant peripheral nerve sheath tumor (MPNST) of the anterior abdominal wall was excised leaving a large defect. The POSSG was used for reconstruction. A large dual mesh was placed to close the defect in the abdominal wall by suturing it to the remnant rim of abdominal muscles. The omental pedicle was brought through a keyhole in the mesh, spread out over the mesh, sutured and covered by split skin grafts. The final graft take was 90 percent.
  
  
  CONCLUSIONS
  The POSSG can be used to reconstruct any size of anterior abdominal wall defects due to the malleable nature of omentum. Its prerequisite however is a dual mesh like PROCEED. The POSSG helps keep the more complex musculofasciocutaneous flaps as lifeboats. It can be used singly where multiple musculofasciocutaneous flaps would otherwise have been required. It can be used in patients with poor prognosis of underlying malignancy. It may be used by general surgeons due to familiarity with anatomy of the relevant structures and lack of need for microsurgical skill.
  
  
  CONCLUSIONS
  The POSSG can be used in reconstruction of abdominal wall defects of any size by general surgeons.
authors.affiliation: Department of General Surgery, Seth G.S. Medical College, K.E.M Hospital, Parel, Mumbai 400012, India. Electronic address: manaypriyadarshini82@gmail.com.
authors.forename: Priyadarshini
authors.initials: P
authors.lastname: Manay
authors.affiliation: Department of General Surgery, Seth G.S. Medical College, K.E.M Hospital, Parel, Mumbai 400012, India.
authors.forename: Monty
authors.initials: M
authors.lastname: Khajanchi
authors.affiliation: Department of General Surgery, Seth G.S. Medical College, K.E.M Hospital, Parel, Mumbai 400012, India.
authors.forename: Ram
authors.initials: R
authors.lastname: Prajapati
authors.affiliation: Department of General Surgery, Seth G.S. Medical College, K.E.M Hospital, Parel, Mumbai 400012, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Satoskar
keywords: Anterior abdominal wall; Dual mesh; Pedicled omental flap (POSSG); Reconstruction; Split skin graft