THE TRANSPELVIC RECTUS-ABDOMINIS FLAP - ITS USE IN THE RECONSTRUCTIONOF EXTENSIVE PERINEAL DEFECTS

We present our experience of rectus abdominis flaps tunnelled transpel vically in 12 patients (mean age 48.4 years, range 19-72 years) with a diverse range of surgical pathologies, the largest reported series to date. Satisfactory obturation of the pelvic cavity and control of rad ionecrotic tissue sepsis was achieved. Average duration of hospital st ay was 17.6 days with a mean follow-up of 18.7 months. The rectus abdo minis flap provides a significant volume of well-vascularised tissue, ideally suited for reconstruction of extensive perineal defects after tumour ablative surgery. When tunnelled transpelvically, the flap is u nique in its ability to obturate the pelvic inlet, eliminating the dis tressing complication of perineal bowel herniation and allowing for pe rineal radiotherapy.