Rectus Femoris Flap as a Choice for Complicated Abdominal Wound Defect Following Appendectomy

Burst abdomen is a difficult case to address, with various risk factors responsible for wound dehiscence, one of which is malnutrition and infection. Several flap options can be used specifically to treat extensive abdominal defects, but there are still few articles discussing the use of the rectus femoris flap, especially in cases of extensive abdominal defects accompanied by infection and malnutrition. This report highlights the use of a rectus femoris flap to resolve the complexity of this issue. We present a case of a 45-year-old man with poor nutritional status who developed an abscess on his abdominal wall accompanied by osteomyelitis in the iliac wing following appendectomy. The rectus femoris flap was chosen because of its availability and convenient location, as the wound defect lies in the lumbar region. We began with debridement and hemipelvectomy, followed by covering the wound with a rectus femoris flap. After 6 months of follow-up, the wound was closed, with no morbidities at the donor site, and motor function in the thigh was preserved. The benefits of the rectus femoris flap include providing greater rotational function and reducing flap tension, highlighting features not found in other flaps. © 2025 The Authors.