Clinical applications of the posterior rectus sheath-peritoneal free flap

Christopher Salgado, G. S. Orlando, J. M. Serletti

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Soft-tissue injuries involving the dorsum of the hand and foot continue to pose complex reconstructive challenges in terms of function and contour. Requirements for coverage include thin, vascularized tissue that supports skin grafts and at the same time provides a gliding surface for tendon excursion. This article reports the authors' clinical experience with the free posterior rectus sheathperitoneal flap for dorsal coverage in three patients. Two patients required dorsal hand coverage; one following acute trauma and another for delayed reconstruction 1 year after near hand replantation. A third patient required dorsal foot coverage for exposed tendons resulting from skin loss secondary, to vasculitis. In all three patients, the flap was harvested through a paramedian incision at the lateral border of the anterior rectus sheath. After opening the anterior rectus sheath, the rectus muscle was elevated off of the posterior rectus sheath and peritoneum. When elevating the muscle, the attachments of the inferior epigastric vessels to the posterior rectus sheath and peritoneum were preserved while ligating any branches of these vessels to the muscle. Segmental intercostal innervation to the muscle was preserved. The deep inferior epigastric vessels were then dissected to their origin to maximize pedicle length and diameter. The maximum dimension of the flaps harvested for the selected cases was 16 x 8 cm. The anterior rectus sheath was closed primarily with non-absorbable suture. Mean follow-up was 1 year, and all flaps survived with excellent contour and good function in all three patients. Complications included a postoperative ileus in one patient, which resolved after 5 days with nasogastric tube decompression.

Original languageEnglish
Pages (from-to)321-326
Number of pages6
JournalPlastic and Reconstructive Surgery
Volume106
Issue number2
StatePublished - Sep 2 2000
Externally publishedYes

Fingerprint

Free Tissue Flaps
Muscles
Hand
Peritoneum
Tendons
Foot
Soft Tissue Injuries
Skin
Ileus
Replantation
Vasculitis
Decompression
Sutures
Transplants
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Salgado, C., Orlando, G. S., & Serletti, J. M. (2000). Clinical applications of the posterior rectus sheath-peritoneal free flap. Plastic and Reconstructive Surgery, 106(2), 321-326.

Clinical applications of the posterior rectus sheath-peritoneal free flap. / Salgado, Christopher; Orlando, G. S.; Serletti, J. M.

In: Plastic and Reconstructive Surgery, Vol. 106, No. 2, 02.09.2000, p. 321-326.

Research output: Contribution to journalArticle

Salgado, C, Orlando, GS & Serletti, JM 2000, 'Clinical applications of the posterior rectus sheath-peritoneal free flap', Plastic and Reconstructive Surgery, vol. 106, no. 2, pp. 321-326.
Salgado, Christopher ; Orlando, G. S. ; Serletti, J. M. / Clinical applications of the posterior rectus sheath-peritoneal free flap. In: Plastic and Reconstructive Surgery. 2000 ; Vol. 106, No. 2. pp. 321-326.
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