Prefabricated Expanded Free Lower Abdominal Skin Flap for Cutaneous Coverage of a Forearm Burn Wound Defect

Abstract

Background

Abdominoplasty is one of the most frequently performed surgical procedures. A number of methods have been described for coverage of forearm skin defects. This report presents a case in which the excess tissue of an abdominoplasty was used for skin and soft tissue defect coverage.

Methods

A woman with a burn scar contracture of the right forearm and postpartum soft tissue laxity of the lower abdomen is presented. A lower abdominal skin flap prefabrication was performed by inserting the transversalis fascia nourished by the deep inferior epigastric vessels subcutaneously. Meanwhile, a tissue expander was placed under the Scarpa’s fascia. After neovascularization followed by a pretransfer delay procedure, the flap was transplanted, and the abdominoplasty was completed 3 months later.

Results

The distal one fifth of the free flap was lost due to venous congestion. After revision and debulking, the final appearance was good. The contour of the abdomen was improved.

Conclusions

Prefabrication techniques and flaps transferred from the abdominal region for head and neck reconstruction are reported and were extended in the current case for extremity reconstruction. This procedure can minimize donor-site morbidity and can expedite both the abdominoplasty and its recovery. However, it cannot take the place of other fasciocutaneous and perforate flaps, especially when the defect is not large. The authors suggest that this procedure be used selectively.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.