Abstract
A rectus abdominis myocutaneous flap has been used to repair the abdominal wall, chest wall, sternum, breast, and groin. We describe a patient in whom a large deformity in the buttock caused by a road crash was repaired with a transverse rectus abdominis myocutaneous (TRAM) flap. Distally-based TRAM flaps provide a good and reliable way of reconstructing the buttock. Its advantages are a long arc of rotation and well-vascularised bulky tissue that serve as a partition and promote quick healing of the defect. However, the flap is not the first choice for traumatic and infected wounds where fatty tissue is not desired.