Huge Abdominal Wall Reconstruction in a Complicated Inguinal Hernia

Hosseinali  Abdolrazaghi; Hossein Zabihi  Mahmoudabadi; Alireza  Naghdipur; Hojjat  Molaei

doi:10.18502/crcp.v9i5.18452

Hosseinali Abdolrazaghi Hand & Reconstructive Surgery Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hossein Zabihi Mahmoudabadi Minimally Invasive Surgery Department, Medicine School, Tehran University of Medical Sciences, Tehran, Iran
Alireza Naghdipur General Surgery Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hojjat Molaei Plastic & Reconstructive surgery Department, Imam Khomeini Hospital Complex, Medicine School, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/crcp.v9i5.18452

Keywords: Anterolateral thigh flap (ALT); Abdominal wall reconstruction; Fournier`s gangrene; Inguinal hernia; Incarceration

Abstract

Inguinal hernia repair is a common surgery that can result in incarceration in somecases. Catastrophic events may be encountered in specialized circumstances, such asFournier’s gangrene, which is an emergent condition. Treatment of debrided skin ofthe abdominal wall is always challenging, particularly in large defects.A 69-year-old man suffered from complications following inguinal hernia repair,which included laparoscopic mesh repair, subsequent right hemicolectomy withanastomosis, leading to ileostomy, Fournier’s gangrene, and eventually a large skindefect in the lower abdomen and perineal area. After multiple sessions of woundtherapy, he underwent abdominal wall reconstruction with two large pedicledanterolateral thigh flaps.Anterolateral thigh flaps, with their robust blood supply, can easily reach the lowerabdomen and cover extensive abdominal skin defects when transferred bilaterally.Level of Evidence: Level V, therapeutic study