Lower abdominal wall reconstruction using the anterior thigh fasciocutaneous flap

Full thickness defects of the lower abdominal wall are uncommon. They can o ccur in congenital abdominal wall defects, acute trauma and following resec tion of soft tissue tumours. In reconstruction of defects not amenable to p rimary closure, three problems need to be addressed: (i) the fascial layer needs to be reconstructed; (ii) stable and sensate skin coverage is needed as the lower abdominal waistline area is subject to pressure; (iii) it is d esirable to restore the contour of the abdominal wall. We present a case with a large area of radiation dermatitis and recurrence of a malignant ovarian tumour in the lower abdominal wall. After en bloc re section the 25 x 6 cm lower abdominal defect was reconstructed with a sensa te anterior thigh fasciocutaneous flap. The vascular supply was reliable an d the outcome was good. The reasons for using this fasciocutaneous flap in preference to the other options are discussed. (C) 1999 The British Associa tion of Plastic Surgeons.