Dual vascular free transverse rectus abdominis myocutaneous flap for hemifacial reconstruction in a vessel-depleted neck

Su Hyun Lee, Hi Jin You, Yun Hwan Lee, Deok Woo Kim

Research output: Contribution to journalArticle

Abstract

Cutaneous squamous cell carcinoma (SCC) is the second most common skin malignancy. This report describes the case of an unusual extensive SCC involving the whole hemiface, which required reconstruction with a combination of a dual vascular free transverse rectus abdominis muscle (TRAM) flap and a skin graft. A 79-year-old woman visited our hospital with multiple large ulcerated erythematous patches on her right hemiface, including the parieto-tem-poral scalp, bulbar and palpebral conjunctiva, cheek, and lip. A preliminary multifocal biopsy was performed in order to determine the resection margin, and the lesion was resected en bloc. Orbital exenteration was also performed. A free TRAM flap was harvested with preserved bilateral pedicles and was anastomosed with a single superior thyroidal vessel. The entire TRAM flap survived. The final pathological examination of the resected specimen confirmed that there was no regional nodal metastasis, perineural invasion, or lymphovascular involvement. The patient was observed for 6 months, and there was no evidence of local recurrence. Usage of a TRAM flap is appropriate for hemifacial reconstruction because the skin of the abdomen matches the color and pliability of the face. Furthermore, we found that the independent attachment of two extra-flap anastomoses to a single recipient vessel can safely result in survival of the flap.

Original languageEnglish
Pages (from-to)88-91
Number of pages4
JournalArchives of Plastic Surgery
Volume47
Issue number1
DOIs
Publication statusPublished - 2020 Jan

Keywords

  • Free flaps
  • Skin neoplasms
  • Squamous cell carcinoma of head and neck

ASJC Scopus subject areas

  • Surgery

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