title: Comparison of vertical and oblique rectus abdominis myocutaneous flaps for pelvic, perineal, and groin reconstruction.
abstract: BACKGROUND
  Wound complications after perineal and groin obliterative procedures are a significant cause of morbidity, particularly following chemoradiation therapy. Vertical and, increasingly, oblique rectus abdominis myocutaneous flaps have been used to fill potential dead space and bring healthy, vascularized tissue into the defect. The authors compared the complications and outcomes of patients undergoing perineal or groin reconstruction with vertical or oblique rectus abdominis myocutaneous flaps. They hypothesized that the oblique flap offers outcomes similar to those of the vertical flap, without an increased risk of complications.
  
  
  METHODS
  All patients who underwent immediate reconstruction of perineal, pelvic, or groin defects using vertical (n=49) or oblique rectus abdominis myocutaneous (n=22) flaps over the past 10 years at the University of Washington Medical Center were reviewed retrospectively. Patient, disease, and obliterative procedure characteristics and donor- and recipient-site complications were compared. Statistical analysis was performed using the t test for continuous variables and Fisher's exact test for categorical variables.
  
  
  RESULTS
  There were no statistically significant differences in major or minor donor- or recipient-site complication rates, need for augmented fascial closure, need for additional flaps, flap loss, readmission, or reoperation rate between the two groups.
  
  
  CONCLUSIONS
  Immediate reconstruction of perineal or groin defects with oblique rectus abdominis myocutaneous flaps results in complication rates similar to those with reconstruction using with vertical flaps. Oblique flap reconstruction is a reasonable and safe alternative, providing several distinct advantages over the vertical flap, including greater arc of rotation, thinner skin paddle, less bulk, and limited fascial harvest.
  
  
  METHODS
  Therapeutic, III.
authors: Seattle, Wash. From the Division of Plastic Surgery, University of Washington.
authors: Patrick D
authors: PD
authors: Combs
authors: Janelle D
authors: JD
authors: Sousa
authors: Otway
authors: O
authors: Louie
authors: Hakim K
authors: HK
authors: Said
authors: Peter C
authors: PC
authors: Neligan
authors: David W
authors: DW
authors: Mathes
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006119:Groin / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000637:transplantation*; D017063:Outcome Assessment, Health Care; D010388:Pelvis / Q000601:surgery*; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D017568:Rectus Abdominis / Q000637:transplantation*; D012189:Retrospective Studies