THE TENSOR FASCIA LATA FREE-FLAP IN ABDOMINAL-WALL RECONSTRUCTION

The pedicled tensor fascia lata flap (TFL flap) is a method of choice for abdominal-wall reconstruction. Frequently, the size and location o f the defect preclude this option. Microsurgical transfer may overcome these disadvantages. Therefore, the ability of the TFL free flap to r econstruct complex abdominal wounds was evaluated. Seven patients with full-thickness abdominal-wall defects reconstructed by TFL Free flaps were reviewed. Their average age was 44.6 years (range: 21 years to 5 9 years); follow-up averaged 10.5 months (range: 2 months to is months ). Fifty-seven percent of the wounds were either infected or contamina ted; the defect averaged 15 cm x 26 cm. Six (85.7 percent) of the woun ds involved the epigastrum. No total flap loss was seen, but three fla ps developed distal tip necrosis (42.9%). Microsurgical transfer of th e TFL free flap overcomes the limitations of the are of rotation seen with the pedicled flap. It increases the vascularity of the distal por tion of the flap. The TFL free flap is therefore an option in abdomina l wounds, particularly those with defects of large size or supraumbili cal location.