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Several surgical methods are performed for the reconstruction of abdominal wall defects after abdominoperineal resection, involving re-suture and free skin grafting. In the complex surgical cases with large abdominal wall defects, the treatment of intestinal fistula and wound infection is challenging. In many cases, they also have had the problems of the control and reposition of a stoma, which has been already present due to the previous unsuccessful surgical procedures. Especially, the case of larger abdominal wall defects with intestinal fistulation, which drains digestive juice into the wound, requires repairing the abdominal wall while fashioning a stoma. This is because a ruptured digestive tract causes infection and inflammation that results in adhesion of the digestive tract, which limits the mobility of both the abdominal wall and bowel. The only method to solve this complex problem is abdominal wall reconstruction with a large vascularized flap and creation of a new stoma on it to separate the wound from drained digestive juice. We present several cases of a large abdominal wall defect, which was reconstructed successfully. Especially, surgical methods using free and perforator flaps are highlighted. These are optimal methods to reconstruct severe abdominal wall defects that involve complications.

Stoma Revision on the Flaps in Cases of Abdominal Wall Defect with Digestive Tract Rupture