title: Coverage of supraumbilical abdominal wall defects: The tunnelled-pedicled ALT technique.
abstract: Abdominal wall defects are a challenge for reconstructive surgeons. Although the utility of anterolateral thigh perforator (ALT) flap has been well established for lower abdominal wall reconstruction, pedicled ALT flap is usually not considered for supraumbilical defects in the most recent algorithms. The purpose of this paper is to report the results of a tunneled pedicled ALT flap for reconstruction of supraumbilical defect from a series of patients. From July 2009 to September2014, six patients underwent delayed abdominal wall coverage using pedicled ALT flaps and reinforcement with polypropylene meshes. Defects occurred after surgical complications and abdominal trauma. Flaps were tunneled beneath the rectus femoris and sartorius muscles to increase the pedicle length. The size of the skin islands ranged from 22-29 × 10-14 cm. All flaps survived and the healing of the wounds was successful. Partial dehiscence of donor site occurred in one patient, and small wound dehiscence due to minimal distal necrosis was observed in another patient. No functional problems were reported in donor site, and no complications occurred in 6-68 months of follow-up. The tunneled pedicled ALT flap may provide a reliable alternative method for abdominal wall reconstruction, including supraumbilical defects. © 2015 Wiley Periodicals, Inc. Microsurgery 37:119-127, 2017.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen Del Rocio University Hospital, Seville, Spain.
authors.forename: Jose-Alberto
authors.initials: JA
authors.lastname: Fernandez-Alvarez
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen Del Rocio University Hospital, Seville, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Barrera-Pulido
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen Del Rocio University Hospital, Seville, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Lagares-Borrego
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen Del Rocio University Hospital, Seville, Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Narros-Gimenez
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen Del Rocio University Hospital, Seville, Spain.
authors.forename: Purificación
authors.initials: P
authors.lastname: Gacto-Sanchez
authors.affiliation: Department of Plastic and Reconstructive Surgery, Virgen Del Rocio University Hospital, Seville, Spain.
authors.forename: Tomas
authors.initials: T
authors.lastname: Gomez-Cia
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply / Q000601:surgery*; D013526:Surgical Mesh; D013848:Thigh / Q000601:surgery*; D014472:Umbilicus; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult