Transosseous transposition of a pedicled rectus abdominis flap to cover hip wounds

Bone-marrow transplantation may be complicated by aseptic necrosis of the f emoral head. Prolonged immunosuppression places the patient at increased ri sk of infection and is of particular concern if replacement arthroplasty is contemplated. Infection of a prosthesis usually requires thorough debridem ent and removal of the device, However, attention must also be paid to the resultant cavity and soft-tissue cover. Several flaps have been resorted fo r this problem, though limitations of flap size may make it difficult to ac hieve both objectives. This report describes the use a pedicled rectus abdo minis Bap that was tunnelled through the acetabulum in order to gain direct access to the hip and allow adequate length both to fill the dead-space an d to provide cover.