Salvage of pedicled anterolateral thigh flap for closure of a massive full-thickness abdominal wall defect using modified Perez protocol for chemical leeching

Study Profile

Design

single case report of pedicled anterolateral thigh (ALT) fasciocutaneous flap salvage using the modified Perez protocol for chemical leeching to manage diffuse venous congestion after post-tumor-resection full-thickness abdominal wall defect coverage; 14-day chemical leeching protocol with slight dosage modification for flap volume (Department of Surgery, Federal Teaching Hospital Ido-Ekiti, and Department of Surgery, Afe Babalola University, Ekiti State, Nigeria)

Sample size (n)

1

Intervention

Modified Perez protocol for chemical leeching applied for 14 days following postoperative day 2 diagnosis of diffuse venous congestion of the pedicled ALT flap; dosage modified to account for the volume of flap tissue; concurrent management with standard postoperative care

Comparator

Not applicable - single-patient case report; comparison to medicinal-leech therapy is narrative only

Primary endpoint

Partial flap salvage and avoidance of visceral exposure of the abdominal wall defect

Primary result

Partial salvage of the flap was achieved by postoperative day 14 with no visceral exposure; residual granulation on the flap was resurfaced with a meshed split-thickness skin graft; authors affirmed the reliability of the Perez chemical-leeching protocol for managing pedicled flap venous congestion; case illustrates an alternative pharmacologic-leech strategy in resource settings where medicinal leech supply may be limited

Follow-up duration

14-day chemical leeching protocol plus subsequent skin grafting and follow-up

PMID

42100608