Supercharged Rectus Abdominis Flap Combined with Pedicled Omental Flap for Complex Chest Wall Reconstruction

We herein report a case of mediastinitis treated with a supercharged rectus abdominis flap combined with a pedicled omental flap.A 78-year-old male patient had, in addition to mediastinitis, sternal osteomyelitis and a skin defect between the clavicles.The prosthetic aortic graft was covered with the pedicled greater omental flap, and the sternal skin defect were closed with the pedicled rectus abdominis myocutaneous flap.During surgery, blood flow on the distal side of the rectus abdominis flap was insufficient.The deep inferior epigastric artery and vein of the rectus abdominis flap were anastomosed with the corresponding vessels of the greater omental flap for supercharge and superdrainage.As a result, the rectus abdominis myocutaneous flap survived, and the wound healed without complications.In combined reconstruction with a greater omental flap and a rectus abdominis flap, a vessel distal to the omental flap can be used for supercharge and superdrainage.