Background: Omental flap has the distinction of being
the foremost flap to be applied in the field of reconstructive
microsurgery. Despite the keen initial interest, the drawback
of a harvest laparotomy led to gradual loss of favour in this
flap. It was the path breaking application of minimal access
surgery for flap harvest, which led to a renewed interest in
omental flap in its new incarnation. In this case series of
laparoscopically harvested microvascular omental transfers,
we explore the flap's unique immunologic and tissue regenerative
properties and resulting outcomes in challenging reconstructive
situations and limb salvage.
Patients and Methods: A retrospective analysis of microvascular
reconstructions with laparoscopically harvested
omental flaps in ten challenging situations. The study evaluated
the indications, procedural details such as operative technique
and time, length of flap vascular pedicle achieved, complications
and outcome.
Results: Provision of vascularized and stable soft tissue
cover with swift resolution of infection in chronic wounds
was achieved in all cases leading to reduced long term morbidity
with negligible complications.
Conclusion: Microvascular omental flap provides large
pliable tissue with characteristic vascular anatomy and unique
set of immune and stem cells that has immense application
in situations of complex three-dimensional reconstruction and
limb salvage. Together with the laparoscopic-assisted harvest
to avoid the morbidity of laparotomy, it presents an effective
solution for those challenging situations that demand more
than the routine options.