Rectus abdominis free-tissue transfer in lower extremity reconstruction: Review of 40 cases

Forty patients who underwent rectus abdominis free-tissue transfer with spl it-thickness skin grafts for reconstruction of the lower extremity are repo rted. The procedures were performed between January. 1992 and December, 199 8. Transfers were utilized for coverage of acute soft-tissue and bone defec ts (18 patients), defects following radical debridement of chronic osteomye litis of the leg and foot (13 patients) or diabetic foot ulcers (eight pati ents), and for unstable scars tone patient). At a mean follow-up of 3.6 yea rs, there was no donor-site morbidity; there were seven local complications - Five superficial flap necroses and two flap congestions. Three flaps wer e totally lost. All patients but one were ambulatory and fully weight-beari ng at the time of review, with consolidation of the fractures and bone defe cts and no evidence of recurrence of infection in the osteomyelitis or diab etic foot ulcer groups. The relatively high success rate (92.5 percent), the ease of surgical disse ction, the consistency and size of the deep inferior epigastric pedicle, th e absence of donor-site morbidity, and relatively low complication rates ma ke the rectus abdominis muscle one of the preferable free-tissue transfers for these authors.