Volume 41, Issue 3 pp. 270-275
CASE REPORT

Free superficial circumflex iliac artery perforator fascial flap for reconstruction of upper abdominal wall with extensive infected herniation: A case report

Ryusuke Sumiya MD

Ryusuke Sumiya MD

Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan

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Reiko Tsukuura MD

Reiko Tsukuura MD

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan

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Fuminori Mihara MD

Fuminori Mihara MD

Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan

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Takumi Yamamoto MD, PhD

Corresponding Author

Takumi Yamamoto MD, PhD

Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan

Correspondence

Takumi Yamamoto, MD, PhD, Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan, Toyama 1-21-1, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan.

Email: [email protected]

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First published: 14 December 2020
Citations: 5

Abstract

Complex abdominal wall reconstruction is challenging, and vascularized fascia is preferred for active infection cases. Pedicled tensor fascia lata flap is commonly used for lower abdominal wall reconstruction, and free vascularized fascial flap based on the lateral circumflex femoral artery (LCFA) is used for upper abdominal wall reconstruction. However, LCFA-based flap transfer requires invasive and time-consuming muscle dissection and a large recipient vessel. The purpose of this report was to present a new application of superficial circumflex iliac artery (SCIA) perforator (SCIP)-based fascial flap for upper abdominal wall reconstruction. A 70-year-old male suffered from a long-lasting extensive abdominal wall herniation complicated with mesh infection and cutaneous fistulae following multiple herniation repair with synthetic mesh. After complete debridement of infected tissues, there was a 29 x 26 cm full-thickness abdominal wall defect. Components separation was performed to minimize the defect size, after which 12 x 7 cm defect remained in the upper abdominal wall. A 20 x 10 cm SCIP deep fascial flap was elevated based on the deep branch of the SCIA. The SCIP flap was transferred to the defect to reconstruct the upper abdominal wall. The SCIP was anastomosed to the deep inferior epigastric artery perforator with supermicrosurgical perforator-to-perforator anastomosis. Postoperative course was uneventful with good functional and esthetic results of the donor and recipient sites 11 months after the surgery. Although further studies are required, SCIP fascial flap may be an option for upper abdominal wall reconstruction.

DATA AVAILABILITY STATEMENT

The datasets analyzed during the current study are not publicly available due to their containing information that could compromise the privacy of research participants but are available from the corresponding author on reasonable request.

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