Pedicled Anterolateral Thigh Flap Reconstruction of Exposed Renal Allograft

Complete abdominal wall dehiscence is an exceedingly rare complication following kidney transplantation. Reconstruction typically consists of abdominally based flaps; however, extensive prior surgeries, ostomies, and limited recipient vessels may necessitate alternative donor sites. This case describes the use of a pedicled anterolateral thigh flap reinforced with vascularized fascia lata to reconstruct a complex abdominal wall defect exposing a renal allograft in a patient with vertebral (V), anogenital (A), cardiac (C), tracheoesophageal (TE), renal (R), and limb (L) system (V.A.C.T.E.R.L.) association and a history of over 70 abdominal operations. The reconstruction was complicated by recurrent perinephric abscess and venous congestion. Successful flap salvage was ultimately achieved through medicinal leech therapy. This case highlights a systematic reconstructive approach in the setting of rare congenital anomalies, complex anatomy, and threatened flap viability.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

A pedicled anterolateral thigh flap with vascularized fascia lata reconstructed an abdominal wall defect exposing a renal allograft in a VACTERL patient; after venous congestion and recurrent perinephric abscess, medicinal leech therapy achieved flap salvage.

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