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  • Innervated vastus lateralis muscle: complementing and completing the anterolateral thigh flap for abdominal wall reconstruction

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Surgery
Innervated vastus lateralis muscle: complementing and completing the anterolateral thigh flap for abdominal wall reconstruction
  1. Pawan Kumar Dixit,
  2. Shilpi Karmakar and
  3. Priyanka Singla
  1. Burns and Plastic Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Shilpi Karmakar; drshilpikarmakar{at}rediffmail.com

Abstract

Reconstruction of composite abdominal wall defects is challenging. An anterolateral thigh (ALT) flap has established itself in the algorithm for abdominal wall reconstruction. Augmenting innervated vastus lateralis (iVL) muscle to ALT has added advantages. We describe previously unreported advantage of ALT with iVL.

A woman in her 30s, suffering from Mullerian adenocarcinoma with metastasis to the right anterior abdominal wall and right inguinal lymph node, was taken for wide local excision and reconstruction. After excision, there was a 15×12 cm defect of the anterior abdominal wall. We reconstructed the defect with prosthetic mesh and pedicled composite ALT and iVL. There was venous congestion in the ALT flap and it could not be salvaged. We debrided the ALT flap and applied split skin graft over iVL. The grafted and donor sites healed well. The patient was able to do moderate strenuous activities. The presence of iVL allowed us to get away with minor procedure and averted the need for another flap.

  • Surgical oncology
  • Plastic and reconstructive surgery
  • General surgery

https://doi.org/10.1136/bcr-2023-258080

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—PKD, SK and PS. The following authors gave final approval of the manuscript—PKD, SK and PS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.