Arch Reconstr Microsurg.  2015 May;24(1):7-12. 10.15596/ARMS.2015.24.1.7.

Long-Term Outcome of Free Rectus Abdominis Musculocutaneous Flap for General Soft-Tissue Reconstruction

• Park J
• Son D
• Song J

• KMID: 1794092
• DOI: http://doi.org/10.15596/ARMS.2015.24.1.7

Abstract

PURPOSE
The rectus abdominis musculocutaneous (RAM) flap has contributed to the efficient reconstruction of soft tissue defects. The flap has the advantage of easy dissection, minimal donor site morbidity, and the constant vascular anatomy with long pedicle. Authors used the free RAM flap to reconstruct multi-located soft tissue defects while still considering functionality and aesthetics. We present the long-term outcomes and versatility of free RAM flaps.
MATERIALS AND METHODS
From 1994 to 2004, all patients who underwent soft tissue reconstruction with free RAM flap were reviewed retrospectively. The site of the reconstruction, vessels of anastomosis, type of RAM flap, and outcomes, including flap success rate, hospital stay after flap transfer, conduction of secondary procedure, flap complications, and donor-site complications were analyzed.
RESULTS
Twenty-one patients underwent 24 free RAM flaps in site of breast, face, upper extremity and lower extremity. Mean follow-up period was 36.1 months (range, 3~156 months). The overall success rate was 92% with only a loss of 2 flaps. Minor complications related to transferred flaps were necrosis of 2 partial flaps, hematoma formation in 3 cases, and a wound infection in 1 case. Donor site morbidity was not observed. Debulking surgery was performed in 4 patients, and scar revision was performed in 3 patients.
CONCLUSION
Free RAM flap is a workhorse flap for general soft-tissue reconstruction with minimal donor site morbidity with aesthetically good results. Thus, the free RAM flaps are versatile, and sturdy for any sites of soft-tissue where reconstruction could be performed.

Keyword

Free tissue flaps; Rectus abdominis; Reconstructive surgical procedures; Treatment outcome

MeSH Terms

Breast
Cicatrix
Esthetics
Follow-Up Studies
Free Tissue Flaps
Hematoma
Humans
Length of Stay
Lower Extremity
Myocutaneous Flap*
Necrosis
Reconstructive Surgical Procedures
Rectus Abdominis*
Retrospective Studies
Tissue Donors
Treatment Outcome
Upper Extremity
Wound Infection