The tensor fascia lata free flap in abdominal-wall reconstruction.

The pedicled tensor fascia lata flap (TFL flap) is a method of choice for abdominal-wall reconstruction. Frequently, the size and location of the defect produce this option. Microsurgical transfer may overcome these disadvantages. Therefore, the ability of the TFL free flap to reconstruct complex abdominal wounds was evaluated. Seven patients with full-thickness abdominal-wall defects reconstructed by TFL free flaps were reviewed. Their average age was 44.6 years (range: 27 years to 59 years); follow-up averaged 10.5 months (range: 2 months to 18 months). Fifty-seven percent of the wounds were either infected or contaminated; the defect averaged 15 cm x 26 cm Six 85.7 percent) of the wounds involved the epigastrum. No total flap loss was seen, but three flaps developed distal tip necrosis (42.9%). Microsurgical transfer of the TFL free flap overcomes the limitations of the arc of rotation seen with the pedicled flap. It increases the vascularity of the distal portion of the flap. The TFL free flap is therefore an option in abdominal wounds, particularly those with defects of large size or supraumbilical location.