Clinical application of free ilio-abdominal perforator flap

Abstract

Objective To introduce clinical experiences of free ilio-abdominal flap pedicled with selective perforating branches. Methods Based on successful clinical application of free iliac flaps, we designed free ilio-abdominal flaps pedicled with selective perforating branches. Thirty such flaps were transferred to repair soft tissue defects in the extremities. There were 12 ilio-abdominal flaps pedicled with the superficial iliac circumflex artery, 14 pedicled with the deep iliac circumflex artery and 4 pedicled with a common trunk of the superficial and deep iliac circumflex arteries. The area of the flaps ranged from 8.0 cm × 6.0 cm to 22.0cm×10.0 cm. Results All 30 flaps survived. The donor sites were closed directly. Postoperative follow-up ranged from 3 to 6 months. The appearances of 12 flaps used to repair forearm and lower leg sites were satisfactory, while 18 flaps used to repair hand and ankle sites needed secondary surgery to debulk. The donor site only had a linear scar, without any complications. Conclusion The ilio-abdominal flap is an ideal flap for soft tissue loss in extremities in that the donor site is discreet and the harvestable area is big. However harvesting of the flap should be adjusted during the surgery based on the diameter and course of the blood vessels because the blood supply of the ilio-abdominal flap can be based on the superficial or deep iliac circumflex arteries, and the perforating branches and cutaneous branches of the flap can vary. Key words: Surgical flaps; Wounds and injuries; Microsurgery; Ilio-abdominal flap