Reconstruction of a Major Paracolostomy Defect Using a Rectus Abdominis Myocutaneous Flap

Paracolostomy abscess is an unusual complication that creates a long-term and costly health care problem, and may prove lethal. We present a patient who developed a major paracolostomy defect following debridement of a paracolostomy abscess. We did not perform laparotomy and relocation of the colostomy because of the risk of complications due to adhesion, as the patient had received two previous abdominal surgeries. We reconstructed the paracolostomy defect with an unilateral, vertical rectus abdominis myocutaneous flap. This flap can be simply harvested. It enhances stability for a contaminated wound and supports the application of a stoma appliance. This technique for mending a large paracolostomy defect has not been reported in the English literature, to our knowledge.