The "sliding door" technique for closure of abdominal wall defects after rectus abdominis musculocutaneous flap transposition.

Radical surgery is often necessary for patients with local recurrences of rectal cancer and for those having carcinoma associated with anal fistula. Treatment may include either total pelvic exenteration or abdominoperineal resection, with extended excision of the perineal area. These radical resection create a huge dead space in the pelvis and a large skin defect in the perineal area, and it is often necessary to reconstruct the pelvic floor using a rectus abdominis musculocutaneous (RAM) flap. However, this procedure creates a large abdominal wall defect and will often result in postoperative wound dehiscence and incisional hernia. Previous studies have described surgical techniques for abdominal wall reconstruction, many of which are highly technical. We report our experience with a “sliding door” technique for abdominal wall reconstruction after RAM flap transposition. I. Patients and methods