G. Maiwald et al., Use of a pedicled greater omentum flap to repair a thoraco-abdominal defect After extensive tumor resection, CHIRURG, 70(5), 1999, pp. 566-570
Patients suffering from long-untreated malignomas of the chest or abdominal
wall may require plastic surgery due to extensive defects after tumor rese
ction. Despite a variety of pedicled or free myocutaneous flaps, there are
defects in which these reconstructional options may not be indicated. In th
ese patients, the omental flaps are a valid alternative. Since a secondary
split skin graft is mandatory with the omentum nap, antibacterial and granu
lation-enhancing xerodressings are required for wound bed conditioning. We
report one patient in whom the omentum flap was used for coverage of an ext
ensive defect after resection of a widespread basal cell carcinoma at the l
ateral thorax and abdominal wall. After wound conditioning with silver-impr
egnated activated charcoal xerodressing (Actisorb) in combination with a hy
droactive polymer dressing (Allevyn), secondary skin grafting was performed
. In this patient fibrosis and calcification of the omentum led to stable a
bdominal wall coverage even without the application of a synthetic mesh.