Arch Plast Surg.  2013 Jan;40(1):28-35. 10.5999/aps.2013.40.1.28.

Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

• Bae SK
• Kang SJ
• Kim JW
• Kim YH
• Sun H

• KMID: 1432628
• DOI: http://doi.org/10.5999/aps.2013.40.1.28

Abstract

BACKGROUND
If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect.
METHODS
From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction.
RESULTS
Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery.
CONCLUSIONS
Using a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

Keyword

Abdominal wound closure techniques; Wound infection; Rectus abdominis

MeSH Terms

Abdominal Wall
Abdominal Wound Closure Techniques
Bandages
Cesarean Section
Debridement
Esthetics
Fascia
Female
Follow-Up Studies
Humans
Infection Control
Length of Stay
Muscles
Myoma
Peritonitis
Pregnancy
Rectus Abdominis
Rupture
Skin
Subcutaneous Tissue
Wound Infection