The use of transposed rectus femoris muscle in the treatment of infected abdominal wounds

A recent publication, where three experienced workers in the field of managing post-operative contaminated open wounds, especially of the abdominal wall, underscores the considerable number of different methods that are in vogue. Infected abdominal wounds are usually treated by debridement, the administration of appropriate antibiotics and wound closure on a delayed basis. In the presence of a surgical implant, the latter is often partially or completely removed depending on the circumstances that led to its insertion. While healing often results, there remain a hard core of recalcitrant cases where multiple operations are necessary to heal the wound. Over 30 years ago a method was introduced to treat a variety of non-healing and infected wounds, namely the use of transposed muscles. Experience shows that this approach is either unknown or rejected by physicians treating patients with recalcitrant wounds and, at times, major ablations are performed. Introduced originally by a general surgeon, the procedure is better known by those engaged in plastic surgery. At our wound center, patients who have been unsuccessfully treated by multiple operations are regularly seen, which indicates that physicians need to be reminded of this proven, but perhaps forgotten, method of management. For this reason an illustrative case report is presented of a patient whose abdominal wall hernia was treated and which resulted in an infected non-healing wound that was successfully managed using a transposed rectus femoris muscle.