Use of a pedicled greater omentum flap to repair a thoraco-abdominal defect after extensive tumor resection [Einsatz der gestielten Omentum-majus-Plastik als thoracoabdomineller Defektersatz nach großflächiger Tumorresektion]

Patients suffering from long-untreated malignomas of the chest or abdominal wall may require plastic surgery due to extensive defects after tumor resection. Despite a variety of pedicled or free myocutaneous flaps, there are defects in which these reconstructional options may not be indicated. In these patients, the omental flaps are a valid alternative. Since a secondary split skin graft is mandatory with the omentum flap, antibacterial and granulation-enhancing xerodressings are required for wound bed conditioning. We report one patient in whom the omentum flap was used for coverage of an extensive defect after resection of a widespread basal cell carcinoma at the lateral thorax and abdominal wall. After wound conditioning with silver-impregnated activated charcoal xerodressing (Actisorb) in combination with a hydroactive polymer dressing (Allevyn), secondary skin grafting was performed. In this patient fibrosis and calcification of the omentum led to stable abdominal wall coverage even without the application of a synthetic mesh.