Identical Rectus Abdominis Donor-Site Morbidity in Compromised and Healthy Patients

ABSTRACT

As microvascular capabilities improve, donor-site complications may become of greater concern. This has become an issue, particularly with the rectus abdominis muscle which is unique, as weakening of abdominal-wall integrity is always a potential problem. The author has reviewed all 50 of his pedicled and free-flap transfers of the rectus abdominis muscle, comparing healthy and chronically ill patients, for elective and emergent indications. Twelve percent of patients had donor-site complications, identical for both healthy and ill patients; 11.4 percent of pedicled flaps and 13.3 percent of free flaps had compromised outcomes. Three hernias occurred as major complications, which probably could not have been avoided. Nevertheless, these frequencies were within the range of expected complications, as with any muscle-flap donor site. The merit of this flap at the recipient site usually justified the risks and, in spite of appropriate trepidation regarding this donor site, the benefit of this flap should not be denied, even for the unhealthy patient.