CASE REPORT article
Front. Surg.
Sec. Reconstructive and Plastic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1679183
This article is part of the Research TopicRecent Advancements and New Developments in Reconstructive SurgeryView all 8 articles
Anterolateral Thigh Flap Combined with Free Fascia Lata Graft for an Adult Abdominal Wall Defect Reconstruction: A Special Case Report
Provisionally accepted
- Ningbo No.6 Hospital, Ningbo, China
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Large abdominal wall defects pose significant reconstructive challenges. Congenital omphalocele persisting untreated into adulthood is exceptionally rare. We present the first documented case in China of an adult female with a giant congenital omphalocele (defect size: 13 cm x 9 cm; defined as a defect >5 cm in diameter) managed with a novel autologous technique. A combined approach utilizing a free left ALT with attached fascia lata and an additional harvested fascia lata strip was employed. Preoperative CT confirmed a sternal cleft, rib hypoplasia, scoliosis, and significant rectus diastasis (max 6.8 cm). The ALT flap provided soft tissue coverage. The attached fascia lata was sutured bilaterally to the anterior rectus sheath. A separate fascia lata strip was interwoven through perforations in the rectus sheaths under tension, reducing diastasis by ~2.5 cm. Microvascular anastomosis connected the flap pedicle to the inferior epigastric artery. Postoperative recovery was uneventful with This is a provisional file, not the final typeset article stable vital signs, no infection, and excellent flap perfusion. At 6-month follow-up, the abdominal contour was significantly improved. The flap exhibited moderate thickness without bulkiness, and there was no visceral protrusion in any position. The thigh donor site healed well. The reconstruction achieved sufficient strength, acceptable aesthetics, and preserved fertility potential. The free ALT flap combined with tensioned fascia lata strips represents an effective, autologous solution for complex, large abdominal wall defects, particularly in rare cases like adult congenital omphalocele, offering robust reconstruction without synthetic materials or secondary surgery.
Keywords: massive abdominal wall defect, reconstructive surgery, Congenital Giant Omphalocele, Adult, Abdominal wall reconstruction
Received: 10 Aug 2025; Accepted: 25 Sep 2025.
Copyright: © 2025 Shen, Sun, Hu, Zhou, Huang and WANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: XIN WANG, dr.wangxin@hotmail.com
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