**Author details**

*Gastrointestinal Stomas*

**4. Conclusion**

flap transfer is required.

**Conflict of interest**

flap concept has many advantages. Parrett et al. revealed in a retrospective study that analyzed 290 flaps that blood circulation of the perforator flaps is supplied from isolated perforating vessels of a stem artery [38]. So, the most significant advantage of the perforator flap is that there is no need to sacrifice any main arteries, which means that there is minimal morbidity at the donor site [41, 42]. Also, microvascular anastomoses have the potential disadvantages that they require

This new concept highlights again that local flaps could be a good option for the coverage of a difficult area of the upper abdomen, whose optimal reconstruction

Bilateral lower abdominal artery perforator flaps provide a well-vascularized skin paddle with an easy procedure, which does not require complicated microsurgical techniques. I believe that the use of this perforator flap is a good option to recon-

Reconstruction of a major abdominal wall defect in patients with a non-healing wound with infection due to continuous contamination from the ruptured ileum is challenging. The main problem is to separate the wound from draining digestive juice. A simple and the recommended method is stoma use, which requires a durable skin component in order to create a new stoma. To resolve these problems,

This manuscript has not benefited from any source of funding support or

grants, and the author has no conflicting financial interest.

high-level surgical skill and prolong the operative period.

was previously thought to be possible with only free flap transfer.

struct large abdominal wall defects associated with many complications.

**28**

Masaki Fujioka1,2

1 Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Ohmura, Nagasaki, Japan

2 Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Ohmura, Nagasaki, Japan

\*Address all correspondence to: inazumahayato7@gmail.com

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
