Incisional and parastomal hernias after harvesting of Vertical Rectus Abdominis Myocutaneous (VRAM) flaps: incidence, treatment options and outcomes

Mathes SJ, Bostwick J 3rd (1977) A rectus abdominis myocutaneous flap to reconstruct abdominal wall defects. Br J Plast Surg 30(4):282–283. https://doi.org/10.1016/0007-1226(77)90118-7

Article  PubMed  CAS  Google Scholar 

Mirza AA, Srinivas KG, Amarendra S, Swamy S, Krishna A, Gopinath KS (2020) Versatility of rectus abdominis myocutaneous flap in primary reconstruction of defects in surgical oncology. Indian J Surg Oncol 11(4):740–745. https://doi.org/10.1007/s13193-020-01213-4

Article  PubMed  PubMed Central  Google Scholar 

Ibrahim AE, Sarhane KA, Pederson JC, Selber JC (2014) Robotic harvest of the rectus abdominis muscle: principles and clinical applications. Semin Plast Surg 28(1):26–31. https://doi.org/10.1055/s-0034-1368164

Article  PubMed  PubMed Central  Google Scholar 

Benedict KC, Songcharoen SJ, Stephens KL, Winter AL, Edwards SR, Campbell CA, Arnold PB (2023) Comparison of inferior gluteal artery perforator flaps versus vertical rectus abdominis musculocutaneous flaps in the reconstruction of perineal wounds. J Plastic Reconstructive Aesthetic Surg : JPRAS 84:514–520. https://doi.org/10.1016/j.bjps.2023.06.020

Article  Google Scholar 

LaBove GA, Evans GR, Biggerstaff B, Richland BK, Lee SA, Banyard DA, Khoshab N (2020) Ten-Year experience with vertical rectus abdominis myocutaneous flap for reconstruction of abdominoperineal resection defects. JPRAS open 27:90–98. https://doi.org/10.1016/j.jpra.2020.11.010

Article  PubMed  PubMed Central  Google Scholar 

Tiernan JP, Leavitt T, Sapci I, Valente MA, Delaney CP, Steele SR, Gorgun E (2022) A comparison of perineal myocutaneous flaps following abdominoperineal excision of the rectum for anorectal pathology. Dis Colon Rectum 65(11):1316–1324. https://doi.org/10.1097/DCR.0000000000002271

Article  PubMed  Google Scholar 

Kent I, Gilshtein H, Montorfano L, Valera RJ, Kahramangil B, Moon S, Freund MR, Newman MI, Wexner SD (2021) Perineal reconstruction after extralevator abdominoperineal resection: Differences among minimally invasive, open, or open with a vertical rectus abdominis myocutaneous flap approach. Surgery 170(5):1342–1346. https://doi.org/10.1016/j.surg.2021.05.027

Article  PubMed  Google Scholar 

Harries RL, Radwan RW, Dewi M, Cubitt J, Warbrick-Smith J, Sadiq O, Beynon J, Evans MD, Drew P, Collaborators SPO (2021) Outcomes following immediate vertical rectus abdominis myocutaneous (VRAM) flap-based perineal reconstruction following resectional surgery for pelvic malignancies. World J Surg 45(7):2290–2297. https://doi.org/10.1007/s00268-021-06044-0

Article  PubMed  Google Scholar 

Tang AM, Spencer N, Parkins K, Bevan V, Taylor G, Markham D, Drew P, Harries RL (2023) Radiological incidence of donor-site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap-based reconstruction following colorectal surgery. Colorectal Disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 25(4):738–746. https://doi.org/10.1111/codi.16400

Article  PubMed  Google Scholar 

Nelson RA, Butler CE (2009) Surgical outcomes of VRAM versus thigh flaps for immediate reconstruction of pelvic and perineal cancer resection defects. Plast Reconstr Surg 123(1):175–183. https://doi.org/10.1097/PRS.0b013e3181904df7

Article  PubMed  CAS  Google Scholar 

Schellerer VS, Bartholomé L, Langheinrich MC, Grützmann R, Horch RE, Merkel S, Weber K (2021) Donor site morbidity of patients receiving vertical rectus abdominis myocutaneous flap for perineal, vaginal or inguinal reconstruction. World J Surg 45(1):132–140. https://doi.org/10.1007/s00268-020-05788-5

Article  PubMed  Google Scholar 

Baumann DP, Butler CE (2010) Component separate on improves outcomes in VRAM flap donor sites with excessive fascial tension. Plastic Reconstructive Surg 126(5):1573–1580. https://doi.org/10.1097/PRS.0b013e3181ef8d00

Article  CAS  Google Scholar 

Daigeler A, Simidjiiska-Belyaeva M, Drücke D, Goertz O, Hirsch T, Soimaru C, Lehnhardt M, Steinau HU (2011) The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients. Langenbecks Arch Surg 396(8):1271–1279. https://doi.org/10.1007/s00423-011-0823-6

Article  PubMed  Google Scholar 

Campbell CA, Butler CE (2011) Use of adjuvant techniques improves surgical outcomes of complex vertical rectus abdominis myocutaneous flap reconstructions of pelvic cancer defects. Plast Reconstr Surg 128(2):447–458. https://doi.org/10.1097/PRS.0b013e31821e6fd2

Article  PubMed  CAS  Google Scholar 

Mortensen AR, Grossmann I, Rosenkilde M, Wara P, Laurberg S, Christensen P (2017) Double-blind randomized controlled trial of collagen mesh for the prevention of abdominal incisional hernia in patients having a vertical rectus abdominis myocutaneus flap during surgery for advanced pelvic malignancy. Colorectal Disease: The official journal of the Association of Coloproctology of Great Britain and Ireland 19(5):491–500. https://doi.org/10.1111/codi.13552

Article  PubMed  CAS  Google Scholar 

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, … Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.) 372:n71. https://doi.org/10.1136/bmj.n71

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ (Clinical research ed) 358:j4008. https://doi.org/10.1136/bmj.j4008

Article  PubMed  Google Scholar 

van Ramshorst GH, Young JM, Solomon MJ (2020) Complications and impact on quality of life of vertical rectus abdominis myocutaneous flaps for reconstruction in pelvic exenteration surgery. Dis Colon Rectum 63(9):1225–1233. https://doi.org/10.1097/DCR.0000000000001632

Article  PubMed  Google Scholar 

Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, … Higgins JP (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ (Clinical research ed.) 355:i4919. https://doi.org/10.1136/bmj.i4919

Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng HY, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Higgins JPT (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 366:l4898. https://doi.org/10.1136/bmj.l4898

Article  PubMed  Google Scholar 

Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O’Connell D, Oxman AD, GRADE Working Group (2004) Grading quality of evidence and strength of recommendations. BMJ (Clinical research ed) 328(7454):1490. https://doi.org/10.1136/bmj.328.7454.1490

Article  Google Scholar 

Touny A, Othman H, Maamoon S, Ramzy S, Elmarakby H (2014) Perineal reconstruction using pedicled vertical rectus abdominis myocutaneous flap (VRAM). J Surg Oncol 110(6):752–757. https://doi.org/10.1002/jso.23692

Article  PubMed  Google Scholar 

Küntscher MV, Mansouri S, Noack N, Hartmann B (2006) Versatility of vertical rectus abdominis musculocutaneous flaps. Microsurgery 26(5):363–369. https://doi.org/10.1002/micr.20253

Article  PubMed  Google Scholar 

Lefevre JH, Parc Y, Kernéis S, Shields C, Touboul E, Chaouat M, Tiret E (2009) Abdomino-perineal resection for anal cancer: impact of a vertical rectus abdominis myocutaneus flap on survival, recurrence, morbidity, and wound healing. Ann Surg 250(5):707–711. https://doi.org/10.1097/SLA.0b013e3181bce334

Article  PubMed  Google Scholar 

McMenamin DM, Clements D, Edwards TJ, Fitton AR, Douie WJ (2011) Rectus abdominis myocutaneous flaps for perineal reconstruction: modifications to the technique based on a large single-centre experience. Ann R Coll Surg Engl 93(5):375–381. https://doi.org/10.1308/003588411X572268

Article  PubMed  PubMed Central  CAS  Google Scholar 

Asaad M, Mitchell D, Slovacek C, Hassan AM, Rajesh A, Liu J, Kapur S, Baumann D, Butler CE (2023) Surgical outcomes of vertical rectus abdominis myocutaneous flap pelvic reconstruction. Plastic Reconstructive Surg https://doi.org/10.1097/PRS.0000000000011233. Advance online publication. https://doi.org/10.1097/PRS.0000000000011233

O’Dowd V, Burke JP, Condon E, Waldron D, Ajmal N, Deasy J, McNamara DA, Coffey JC (2014) Vertical rectus abdominis myocutaneous flap and quality of life following abdominoperineal excision for rectal cancer: a multi- institutional study. Tech Coloproctol 18(10):901–906. https://doi.org/10.1007/s10151-014-1156-6

Article  PubMed  CAS  Google Scholar 

Espinosa-de-Los-Monteros A, Arista-de la Torre L, Vergara-Fernandez O, Salgado-Nesme N (2016) Contralateral component separation technique for abdominal wall closure in patients undergoing vertical rectus abdominis myocutaneous flap transposition for pelvic exenteration reconstruction. Ann Plast Surg 77(1):90–92. https://doi.org/10.1097/SAP.0000000000000327

Article  PubMed  CAS  Google Scholar 

Eker H (2014) Abdominal Wall Hernia: new perspectives for clinical research. Retrieved from http://hdl.handle.net/1765/50265

Pérez-García A, García-Granero Á, Thione A, Frasson M, Sánchez-García A, Salmerón-González E, Simón E, Domingo S, García-Granero E (2022) Extended vertical rectus abdominis myocutaneous flap for reconstruction of large pelviperineal defects following oncologic resection. J Surg Oncol 126(8):1383–1388. https://doi.org/10.1002/jso.27068

Article  PubMed  Google Scholar 

Lozada Hernández EE, Hernández Bonilla JP, Hinojosa Ugarte D, Magdaleno García M, Mayagoitía González JC, Zúñiga Vázquez LA, Obregón Moreno E, Jiménez Herevia AE, Cethorth Fonseca RK, Ramírez GP (2023) Abdominal wound dehiscence and incisional hernia prevention in midline laparotomy: a systematic review and network meta-analysis. Langenbecks Arch Surg 408(1):268.

Comments (0)

No login
gif