Rectus Abdominis Myocutaneous Flap in Cancer Surgery: A Versatile Flap for Wound Coverage Around the Trunk

摘要

Rectus abdominis myocutaneous flap (RAMF) was used to cover the wide defect created after excisional surgery of 42 patients of carcinoma breast, 6 of penile cancer with inguinal metastasis and 2 of carcinoma anal canal and 2 of sarcoma chest wall. Complications of RAMF included cuticular necrosis, wound infection, seroma formation, flap edema which was managed conservatively or by minor surgical procedures. Introduction The rectus abdominis myocutaneous flap (RAMF), first described by Mathes and Bostwick to re-construct defects of the abdominal wall (1), has become a workhorse in reconstructive plastic surgery. As a bipedicled flap based superiorly on the superior epigastric vessels, it is used for breast and chest wall reconstruction and based inferiorly on the inferior epigastric vessels, it has been used for reconstruction of groin defects, vulval, perineal and vaginoperineal defects (2,3,4). So this flap has the versatility of being used from the trunk to the groin area. RAMF can be used both for covering the wide defect and also for the cosmetic reason (5,6). We review our experience with rectus abdominis myocutaneous flap for coverage of the wide defect after cancer surgery. Patients and Methods Fifty two patients underwent RAMF coverage in one surgical unit. Forty two patients of locally advanced breast carcinoma underwent neoadjuvant chemotherapy followed by mastectomy leaving a large defect on the chest wall( Figure 1). The flap was used to cover the chest wall defect, in two patients following excision of sarcoma of chest wall.