Lower back coverage with endoscopically harvested pedicled greater omental flap.

An alternative surgical treatment is proposed here for radionecrosis of the lower back. A 78-year-old patient was treated successfully for a nonhealing ulcer with a pedicled omental flap. The omentum was harvested endoscopically and brought out of abdominal cavity through a limited incision on lateral left side of abdominal wall. The omentum was then tunneled to the back for coverage the lower back. The combination of an endoscopic harvest of an omental flap performed by a general surgeon and wound debridement and skin grafting of the omentum by a plastic surgeon allows minimal donor-site morbidity and avoids the use of delicate microsurgical technique. Additionally, omentum is an ideal flap for the treatment of radionecrosis.