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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Tunnelled tensor fascia lata flap for complex abdominal wall reconstruction
  1. Frederick Wang1,
  2. Samuel Buonocore2,
  3. Deepak Narayan2
  1. 1Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California, USA
  2. 2Section of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Deepak Narayan, deepak.narayan{at}


This study describes the treatment of two patients with recurrent, infected abdominal wall defects using bilateral delayed and tunnelled pedicled tensor fascia lata (TFL) myofascial flaps. TFL flaps were elevated and delayed for 4 weeks in both cases. In the second case, Parietex Composite mesh was positioned underneath the TFL flap and allowed to incorporate. After a delay of 4 weeks, the flaps were harvested and tunnelled subcutaneously to repair the abdominal wall defect. Both patients have stable repairs but had donor site seromas requiring drainage. Cadaver dissection was also performed to identify structures related to TFL flap harvest. We identified a variant of lateral femoral cutaneous nerve that traversed the TFL flap, necessitating meticulous dissection during surgery. In summary, we describe a new technique of incorporating mesh into the TFL prior to flap harvest for reconstruction of complex abdominal wall.

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  • Competing interests None.

  • Patient consent Obtained.

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