Case series: pedicled vertical rectus myocutaneous flaps for cover of breast and perineal defects—a 2-year review in our centre

Abstract

Colorectal carcinoma is the most common cancer afflicting both Singaporean men and women; whereas, breast carcinoma is the most frequent female-specific cancer according to the report published by the Singapore Cancer Registry on cancer trends from 2003 to 2007. As such, breast and perineal defects requiring soft tissue cover is a challenging occurrence after initial tumour surgery by the breast and colorectal surgeons, especially for fungating breast tumours and very low colorectal carcinomas, respectively. In Tan Tock Seng Hospital prior to 2007, many of these patients may have had their wounds skin-grafted or allowed to heal by secondary intention. This often involved prolonged hospital stay, difficult wound care and significant morbidity as well as a negative impact on the quality of life for these patients. Pedicled vertical rectus myocutaneous (VRAM) flaps were then introduced for cover of these defects as an effective method of reducing these negative aspects of patient care. This case series aims to review the efficacy of the VRAM flap in achieving this within a 2-year period. Over this period, the VRAM flap has shown to decrease length of hospital stay, reduction of the duration to commencement of adjuvant therapy, and also decrease in the difficulty of wound care as well as the complication rate.