Abstract

BackgroundThe free flap transfer of a latissimus dorsi flap (LDF) for the closure of sacral wound defects after pelvic exenteration and radiation therapy offers a successful tool of the plastic surgeon. This case report shows the successful coverage using an upstream arterio-venous (AV) loop in combination with an LDF.Case presentationWe describe the case of a patient who underwent a pelvic exenteration and radiation therapy due to a local recurrence of rectal cancer. The initially used VRAM flap could not ensure a satisfactorily wound closure. An interdisciplinary approach first yielded an AV loop using both greater saphenous veins and was connected to the arteria and vena femoris followed by a free LDF transfer, which was performed 11 days later. The result was an excellent reconstructive and plastic coverage of the sacral wound defect with a well-perfused LDF. The long-term result showed a perfectly integrated flap in the sacral region.ConclusionWe recommend the free LDF for the coverage of large wound defects in irradiated areas after the failure of VRAM flap. If an AV loop is necessary within the flap transfer, we recommend conducting two procedures to guarantee the perfusion of the AV loop.

Highlights

  • The free flap transfer of a latissimus dorsi flap (LDF) for the closure of sacral wound defects after pelvic exenteration and radiation therapy offers a successful tool of the plastic surgeon

  • We present a successful interdisciplinary reconstructive case of wound closure of a wide sacral wound defect using a free latissimus dorsi flap (LDF) in combination with an arterio-venous loop (AV) as the perfusion conduit

  • The patient underwent multiple surgeries and pelvic exenteration suffering from a colorectal cancer recurrence in an advanced stage

Read more

Summary

Conclusion

We recommend the free LDF for the coverage of large wound defects in irradiated areas after the failure of VRAM flap.

Background
Findings
Funding None
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call