Page 328 - Read Online

Moores et al. Plast Aesthet Res 2018;5:44 I http://dx.doi.org/10.20517/2347-9264.2018.32 Page 5 of 6

always the case that a protuberant abdomen contains a large omental drape, as in many cases mesenteric fat
makes up a good proportion of intra-abdominal adiposity in the obese population.

The importance of disinserting the deep lamella of the omentum from the transverse colon cannot be
overstated for achieving sufficient length for extra-anatomic applications. Furthermore, by unfurling the
internal and external lamellae the length of the apparent omentum may theoretically be doubled.

Though GI complications are known to result from omental flaps, in our patient it is not clear if GI
symptoms are a complication of the intervention, or if they are reflective of his inciting pathology. For,
the chest pain that he initially underwent negative coronary angiography for was ultimately attributed
[5]
to recurrent upper GI symptomatology . The possibility that these GI complaints are a complication of
omental flap is worthy of consideration, and if other pedicled flaps are available in a patient such as this,
avoiding these complications should be of prime consideration.

In conclusion, we propose that the pedicled omental flap be considered as a viable option for extra-
abdominal vascular coverage option in the groin when either, the abdomen is already open for proximal
vascular reconstruction, or when local muscular flap options have been exhausted, or in any case where
circumferential graft coverage is required in a confined space.

DECLARATIONS
Authors’ contributions
Authorship and editing of the manuscript, participation in the procedure discussed: Moores NG, Pannucci CJ

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
IRB approval was not required for this case report.

Consent for publication
Consent was obtained from the patient for publication of images and details of the clinical case discussed.

Copyright
© The Author(s) 2018.

REFERENCES
1. Shokrollahi K, Whitker I, Nahai F. Flaps: practical reconstructive surgery. NY: Thieme; 2017.
2. Hoballah JJ, Mohan C, Nazzal MM, Corson JD. The use of omental flaps in abdominal aortic surgery: a review and description of a simple
technique. Ann Vasc Surg 1998;12:292-5.
3. Turner-Warwick RT, Wynne EJ, Handley-Ashken M. The use of the omental pedicle graft in the repair and reconstruction of the urinary
tract. Br J Surg 1967;54:849-53.
4. Giordano PA, Griffet J, Argenson C. Pedicled greater omentum transferred to the spine in a case of postoperative infection. Plast Reconstr
Surg 1994;93:1508-11.