New technical approach for the repair of an abdominal wall defect after a transverse rectus abdominis myocutaneous flap: a case report

<p>Abstract</p> <p>Introduction</p> <p>Breast reconstruction with autologous tissue transfer is now a standard operation, but abnormalities of the abdominal wall contour represent a complication which has led surgeons to invent techniques to minimize the morbidity of the donor site.</p> <p>Case presentation</p> <p>We report the case of a woman who had bilateral transverse rectus abdominis myocutaneous flap (TRAM-flap) breast reconstruction. The surgery led to the patient developing an enormous abdominal bulge that caused her disability in terms of abdominal wall and bowel function, pain and contour. In the absence of rectus muscle, the large defect was repaired using a combination of the abdominal wall component separation technique of Ramirez et al and additional mesh augmentation with a lightweight, large-pore polypropylene mesh (Ultrapro^®).</p> <p>Conclusion</p> <p>The procedure of Ramirez et al is helpful in achieving a tension-free closure of large defects in the anterior abdominal wall. The additional mesh augmentation allows reinforcement of the thinned lateral abdominal wall.</p

Fat grafting in soft tissue augmentation

Autologous fat grafting has become widely accepted as a reliable option for volume restoration. This includes not only posttraumatic soft tissue defects but also aesthetic, congenital and postsurgical volume deficits. Used as an alternative to commercial injectable fillers, autologous fat has the advantages of being abundant, nonimmunogenic and free from some of the potential limitations of foreign materials. In addition to providing volume, autogenous fat is also used to improve the quality and texture of the overlying skin, especially in cases of scarring secondary to acne, burns and postirradiation injuries. However, further studies are still needed to fully understand the benefits and the regenerative potential of adipose-derived mesenchymal stem cells (ASCs)