Free tensor fasciae latae flap reconstruction of defects of the chest and abdominal wall: selection of recipient vessels. 1996

A J Penington, and D R Theile, and A M MacLeod, and W A Morrison
Bernard O'Brien Microsurgery Research Institute, St Vincent's Hospital, Fitzroy, Melbourne, Australia.

Reconstruction of a full thickness defect of the abdominal or chest wall requires a combination of a rigid or semi-rigid layer and skin cover. The tensor fasciae latae (TFL) flap is unique in that it provides both of these in substantial quantities, but the most difficult aspect of using this flap in the anterior chest and abdomen is finding suitable recipient vessels. We describe a series of nine cases in which full thickness defects of the chest and abdominal wall were repaired using free vascularised TFL flaps. The recipient vessels included the gastroepiploic vessels (n = 2), the deep inferior epigastric artery (n = 3), the internal mammary artery (n = 2), and the superior thyroid and acromiothoracic arteries (n = 1 each). The gastroepiploic and internal mammary vessels are preferred because of their reliability and because the flap pedicle enters the centre of the deep surface of the flap so that if these vessels are used, circumferential tight closure of the fascial layer can be achieved, with consequent decreased risk of vessel kinking and future herniation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010025 Osteoradionecrosis Necrosis of bone following radiation injury. Osteoradionecroses
D005260 Female Females
D006555 Hernia, Ventral A hernia caused by weakness of the anterior ABDOMINAL WALL due to midline defects, previous incisions, or increased intra-abdominal pressure. Ventral hernias include UMBILICAL HERNIA, incisional, epigastric, and spigelian hernias. Ventral Hernia,Hernias, Ventral,Ventral Hernias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000009 Abdominal Muscles Muscles forming the ABDOMINAL WALL including RECTUS ABDOMINIS; ABDOMINAL OBLIQUE MUSCLES, transversus abdominis, pyramidalis muscles and quadratus abdominis. Cremaster Muscle,Pyramidalis Muscle,Quadratus Abdominis,Transverse Abdominal,Transversus Abdominis,Abdominal Muscle,Abdominal, Transverse,Abdominals, Transverse,Abdomini, Quadratus,Abdominis, Quadratus,Cremaster Muscles,Muscle, Abdominal,Muscle, Cremaster,Muscle, Pyramidalis,Muscles, Abdominal,Muscles, Cremaster,Muscles, Pyramidalis,Pyramidalis Muscles,Quadratus Abdomini,Transverse Abdominals
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001158 Arteries The vessels carrying blood away from the heart. Artery

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