Deep inferior epigastric vessel-pedicled, muscle-sparing rectus abdominis myocutaneous (RAM) flap for reconstruction of soft tissue defects in pelvic area.

Large soft tissue reconstruction in pelvic area is rare but remains challenging. Between August of 2000 and March of 2014, five patients underwent soft tissue reconstruction in pelvic area using deep inferior epigastric vessel-pedicled, muscle-sparing RAM flap. The soft tissue defects located in anterior iliac spine in three cases, lower buttock in one case, contralateral lower buttock and perineal region in one case. The size of the flaps ranged from 13 × 7 cm to 25 × 9 cm. All flaps were harvested in muscle-sparing form. Lateral two-thirds of rectus abdominis muscle and anterior sheath of the rectus abdominis muscle were harvested with the flap in disc or bar shape. All five flaps survived uneventfully. During the follow-up, no ventral hernias occurred in donor sites.