USE OF THE “VERTICAL RECTUS ABDOMINIS MYOCUTANEOUS FLAP” MODIFIED FOR PELVIC RECONSTRUCTION AFTER TRAUMATIC REMOVAL OF THE HEMIPELVIS

Abstract

Reconstructive surgery in case pelvis defect is a technical challenge. It takes into account the etiology, the general condition of the patient; the location and size of the defect. Pedicled musculocutaneous flaps is necessary in case of deep and large defect. The rectus abdominis flap is frequently used. Our observation demonstrates the difficulties and technical particularities of reconstructing a large traumatic defect. It is a rupture of the hemipelvis following a traffic accident, exposing the peritoneum, part of the bladder and the anal canal. The use of fasciocutaneous flap was doomed to necrosis. Our recourse was the use of the "vertical rectus abdominis myocutaneous flap" (VRAM) by making a technical modification. The muscle was dissected separately from the fascia. This allowed us to spread it out and cover a wider area. Complete cutaneous coverage was provided by using two fasciocutaneous flaps: hypogastric and perineal. Good healing was obtained, and the patient received a prosthesis.