Abstract
Reconstruction of extensive limb defects is particularly difficult when standard flaps
like the anterolateral thigh flap, latissimus dorsi (LD) flap, or the less popular
large flap, boomerang-shaped extended rectus abdominis (BERAM) flap, are insufficient
to cover the extensiveness of the raw area, even after extending with vein grafts.
The BERAM and LD myocutaneous flap combines two flap areas into a single tissue unit,
offering a novel solution to the issue. Interposition vein grafts help extending the
reach further and avoids the anastomosis in a probable zone of injury area. In our
experience, it gives the largest possible tissue for coverage compared to any two
separate free flaps especially in children with a good caliber, reliable pedicle.
Keywords
soft tissue reconstruction of extremities - longest free flap - boomerang-shaped extended
rectus abdominis myocutaneous flap
