Gynecologic reconstruction with a rectus abdominis myocutaneous flap: An update

Jay W. Carlson, Jonathan R. Carter, Andrew K. Saltzman, Linda F. Carson, Jeffrey M. Fowler, Leo B. Twiggs

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

This series reports the outcomes and significant complications associated with the rectus myocutaneous flap when used for pelvic or inguinal reconstruction in patients with gynecologic cancers. Perioperative variables were retrospectively reviewed to identify social and medical risk factors as well as intraoperative and postoperative complications that predisposed to rectus flap failure. Fifteen patients with gynecologic malignancies underwent reconstructive procedures using a vertically oriented rectus abdominis myocutaneous flap for either vaginal (n = 14) or inguinal (n = 1) reconstruction. The patients' primary cancers were cervical (n = 11), rectal (n = 1), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1). The median age was 50 years. The median follow-up was 17 months. All flaps were mobilized in conjunction with a radical salvage operation. There were no cases of vaginal prolapse and no abdominal wound infections. However, 4 patients (27%) had major postoperative morbidity in this small series. There was one wound dehiscence and three episodes of necrosis of the subcutaneous and cutaneous portions of the flap. All 4 of these patients required additional operative intervention or debridement. Eleven patients had complete healing of the flap. The rectus abdominis myocutaneous flap is a valuable option for gynecologic reconstructive procedures. Perioperative strategies for improving flap viability include the identification of risk factors that may compromise flap perfusions such as prior abdominal incisions, peripheral vascular disease, and obesity. Meticulous surgical technique is required to preserve the vascular pedicle. These strategies may be useful in preoperative counseling, the perioperative evaluation, and the intraoperative management.

Original languageEnglish
Pages (from-to)364-368
Number of pages5
JournalGynecologic Oncology
Volume61
Issue number3
DOIs
StatePublished - Jun 1 1996
Externally publishedYes

Fingerprint

Rectus Abdominis
Myocutaneous Flap
Groin
Uterine Prolapse
Peripheral Vascular Diseases
Intraoperative Complications
Debridement
Wound Infection
Uterine Cervical Neoplasms
Blood Vessels
Counseling
Neoplasms
Necrosis
Perfusion
Obesity
Morbidity
Skin
Wounds and Injuries

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Carlson, J. W., Carter, J. R., Saltzman, A. K., Carson, L. F., Fowler, J. M., & Twiggs, L. B. (1996). Gynecologic reconstruction with a rectus abdominis myocutaneous flap: An update. Gynecologic Oncology, 61(3), 364-368. https://doi.org/10.1006/gyno.1996.0157

Gynecologic reconstruction with a rectus abdominis myocutaneous flap : An update. / Carlson, Jay W.; Carter, Jonathan R.; Saltzman, Andrew K.; Carson, Linda F.; Fowler, Jeffrey M.; Twiggs, Leo B.

In: Gynecologic Oncology, Vol. 61, No. 3, 01.06.1996, p. 364-368.

Research output: Contribution to journalArticle

Carlson, JW, Carter, JR, Saltzman, AK, Carson, LF, Fowler, JM & Twiggs, LB 1996, 'Gynecologic reconstruction with a rectus abdominis myocutaneous flap: An update', Gynecologic Oncology, vol. 61, no. 3, pp. 364-368. https://doi.org/10.1006/gyno.1996.0157
Carlson JW, Carter JR, Saltzman AK, Carson LF, Fowler JM, Twiggs LB. Gynecologic reconstruction with a rectus abdominis myocutaneous flap: An update. Gynecologic Oncology. 1996 Jun 1;61(3):364-368. https://doi.org/10.1006/gyno.1996.0157
Carlson, Jay W. ; Carter, Jonathan R. ; Saltzman, Andrew K. ; Carson, Linda F. ; Fowler, Jeffrey M. ; Twiggs, Leo B. / Gynecologic reconstruction with a rectus abdominis myocutaneous flap : An update. In: Gynecologic Oncology. 1996 ; Vol. 61, No. 3. pp. 364-368.
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