FIG. 26-16. The omentum has been mobilized entirely down to the left gastroepiploic vascular stalk. Here the omentum is stretched across the chest and axilla and down onto the medial surface of the arm.
FIG. 26-17. The omentum is being tunneled to the chest skin graft area, which has been removed.
FIG. 26-18. The arm flaps are mobilized to cover the transferred omentum.
FIG. 26-20. Early postoperative results show skin graft well taken on the omentum on the chest wall and well-healed scars in the arm.
FIG. 26-21. Late follow-up shows considerable atrophy of the omentum on the chest wall but less retraction across the axilla and more mobility of the shoulder. Relief of the arm edema was partial. Subjectively, the patient felt that the extremity was lighter, more mobile, and less tight.
|| Microvascular transplantation of the omentum was made for lymphedema after mastectomy.
FIG. 26-22. Massive edema of the right upper extremity after radical mastectomy some 8 years previously.
FIG. 26-25. The omentum has been spread out over the medial surface of the arm and forearm under flaps which were elevated at the fascial level. Anastomosis of the omental vessels was accomplished between proximal branches of the brachial vein and arteries.
FIG. 26-26. Late follow-up shows marked reduction in edema over the dorsum of the hand.
1. McLean, D.H., and Buncke, H.J.: Autotransplant of omentum to a large scalp defect with microsurgical revascularization. Plast. Reconstr. Surg. 49:266, 1972.