Reconstruction of a high-energy penetrating injury from the abdomen to the sacral area using a latissimus dorsi free flap with monofilament polypropylene mesh and pedicled flap rotation: a case report

A 50-year-old man was transferred to a level I trauma center for penetrating injury. Industrial metal had penetrated his trunk, and he injured in internal organs. The organs were treated by the surgery team. peritoneum reconstructed with artificial dermal matrix graft. wound managed negative-pressure therapy, several debridement procedures performed. full-thickness abdominal defect covered monofilament polypropylene mesh(Parietene mesh, 30×30 cm). latissimus dorsi flap elevated musculocutaneous measured 50×30 cm, 6-cm thoracodorsal artery pedicle. Microvascular anastomosis performed using left femoral arteries. Two weeks later, we local rotation based on gluteal perforator sacral area. Polypropylene mesh successfully inserted without complications. Combining free can be an effective method reconstructing large wounds trunk.