Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities

Background: A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the la...

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Main Authors: Ashok R Koul, Sushil Nahar, Jagdish Prabhu, Subhash M Kale, H P Praveen Kumar
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2011-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.ijps.org/article.asp?issn=0970-0358;year=2011;volume=44;issue=3;spage=396;epage=404;aulast=Koul
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spelling doaj-e1c447c469014afdb9bd57609d1684482020-11-25T03:32:08ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2011-01-0144339640410.4103/0970-0358.90808Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremitiesAshok R KoulSushil NaharJagdish PrabhuSubhash M KaleH P Praveen KumarBackground: A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Abdominis Myocutaneous (BERAM) flap. This flap is the slightly modified and "free" version of a similar flap described by Ian Taylor in 1983. Materials and Methods: This is a retrospective study of patients who underwent free BERAM flap reconstruction of soft tissue defects of extremity over the last 3 years. We also did a clinical study on 30 volunteers to compare the length of flap available using our design of BERAM flap with the maximum available flap length of LD and ALT flaps, using standard markings. Results: Our clinical experience of nine cases combined with the results of our clinical study has confirmed that our design of BERAM flap consistently provides a flap length which is 32.6% longer than the standard LD flap and 42.2% longer than the standard ALT flap in adults. The difference is even more marked in children. The BERAM flap is consistently reliable as long as the distal end is not extended beyond the mid-axillary line. Conclusion: BERAM flap is simple in design, easy to harvest, reliable and provides the longest possible free skin/myocutaneous flap in the body. It is a useful new alternative for covering long soft tissue defects in the limbs.http://www.ijps.org/article.asp?issn=0970-0358;year=2011;volume=44;issue=3;spage=396;epage=404;aulast=KoulExtended rectus abdominis free flaplongest myocutaneous free flapsoft tissue reconstruction of extremities
collection DOAJ
language English
format Article
sources DOAJ
author Ashok R Koul
Sushil Nahar
Jagdish Prabhu
Subhash M Kale
H P Praveen Kumar
spellingShingle Ashok R Koul
Sushil Nahar
Jagdish Prabhu
Subhash M Kale
H P Praveen Kumar
Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
Indian Journal of Plastic Surgery
Extended rectus abdominis free flap
longest myocutaneous free flap
soft tissue reconstruction of extremities
author_facet Ashok R Koul
Sushil Nahar
Jagdish Prabhu
Subhash M Kale
H P Praveen Kumar
author_sort Ashok R Koul
title Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
title_short Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
title_full Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
title_fullStr Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
title_full_unstemmed Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
title_sort free boomerang-shaped extended rectus abdominis myocutaneous flap: the longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities
publisher Thieme Medical Publishers, Inc.
series Indian Journal of Plastic Surgery
issn 0970-0358
1998-376X
publishDate 2011-01-01
description Background: A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Abdominis Myocutaneous (BERAM) flap. This flap is the slightly modified and "free" version of a similar flap described by Ian Taylor in 1983. Materials and Methods: This is a retrospective study of patients who underwent free BERAM flap reconstruction of soft tissue defects of extremity over the last 3 years. We also did a clinical study on 30 volunteers to compare the length of flap available using our design of BERAM flap with the maximum available flap length of LD and ALT flaps, using standard markings. Results: Our clinical experience of nine cases combined with the results of our clinical study has confirmed that our design of BERAM flap consistently provides a flap length which is 32.6% longer than the standard LD flap and 42.2% longer than the standard ALT flap in adults. The difference is even more marked in children. The BERAM flap is consistently reliable as long as the distal end is not extended beyond the mid-axillary line. Conclusion: BERAM flap is simple in design, easy to harvest, reliable and provides the longest possible free skin/myocutaneous flap in the body. It is a useful new alternative for covering long soft tissue defects in the limbs.
topic Extended rectus abdominis free flap
longest myocutaneous free flap
soft tissue reconstruction of extremities
url http://www.ijps.org/article.asp?issn=0970-0358;year=2011;volume=44;issue=3;spage=396;epage=404;aulast=Koul
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