Wamalwa A O, Khainga S O
Plastic Surgeon, Plastic Surgery & Burns Unit, Kenyatta National Hospital, P.O. Box 2572-00202, Nairobi, Kenya.
Department of Surgery (Plastic), University of Nairobi, P.O. Box 2212-00202, Nairobi, Kenya.
JPRAS Open. 2019 Nov 13;23:11-18. doi: 10.1016/j.jpra.2019.11.002. eCollection 2020 Mar.
Although routinely utilized in reconstruction of groin, perineal and thigh defects, the pedicled vertical rectus abdominis myocutaneous (VRAM) flap has only once been previously reported for coverage of above knee amputation (AKA) stumps. A 36 year old man sustained a traumatic above knee amputation after stepping on an improvised explosive device (IED). Following several sessions of debridement, an ipsilateral pedicled VRAM flap was utilized to provide padded soft tissue coverage and maintain bone length (6 cm below the greater trochanter), avoiding both a debilitating hip disarticulation and a need for a free flap. We describe this procedure, report the outcomes and discuss considerations for utilizing this flap.
尽管带蒂腹直肌肌皮瓣（VRAM）常用于腹股沟、会阴和大腿缺损的重建，但此前仅有一次报道用于覆盖膝上截肢（AKA）残端。一名36岁男性在踩到简易爆炸装置（IED）后遭受创伤性膝上截肢。经过多次清创后，采用同侧带蒂VRAM瓣提供带衬垫的软组织覆盖并维持骨长度（大转子下方6厘米），避免了致残性髋关节离断术和游离瓣的需求。我们描述了该手术，报告了结果并讨论了使用该皮瓣的注意事项。
