Pedicled Anterolateral Thigh Flap Reconstruction of Exposed Renal Allograft

Authors

• Iris Y. Brammer, Department of Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist.
• David Rezko, Wake Forest University School of Medicine, Winston-Salem, NC.
• Thomas C. Rodrigues, Wake Forest University School of Medicine, Winston-Salem, NC.
• Mason A. Sutherland, Department of Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist.
• Kelsey M. Lloyd, Department of Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist.
• Kyle E. Robinson, Department of Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist.

Document Type

Journal Article

Publication Date

3-23-2026

Journal

Annals of plastic surgery

DOI

10.1097/SAP.0000000000004728

Keywords

VACTERL/ VATER; abdominal wall reconstruction; anterolateral thigh flap; renal transplant

Abstract

Complete abdominal wall dehiscence is an exceedingly rare complication following kidney transplantation. Reconstruction typically consists of abdominally based flaps; however, extensive prior surgeries, ostomies, and limited recipient vessels may necessitate alternative donor sites. This case describes the use of a pedicled anterolateral thigh flap reinforced with vascularized fascia lata to reconstruct a complex abdominal wall defect exposing a renal allograft in a patient with vertebral (V), anogenital (A), cardiac (C), tracheoesophageal (TE), renal (R), and limb (L) system (V.A.C.T.E.R.L.) association and a history of over 70 abdominal operations. The reconstruction was complicated by recurrent perinephric abscess and venous congestion. Successful flap salvage was ultimately achieved through medicinal leech therapy. This case highlights a systematic reconstructive approach in the setting of rare congenital anomalies, complex anatomy, and threatened flap viability.

APA Citation

Brammer, Iris Y.; Rezko, David; Rodrigues, Thomas C.; Sutherland, Mason A.; Lloyd, Kelsey M.; and Robinson, Kyle E., "Pedicled Anterolateral Thigh Flap Reconstruction of Exposed Renal Allograft" (2026). GW Authored Works. Paper 8848.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8848

Department

School of Medicine and Health Sciences Student Works