Abdominal Flap Reconstruction Over Necrotic Skin Post Renal Transplantation: A Case Report

Background: Although wound complications post renal transplantation procedure is not strange, presenting with loss of skin at the right lower quadrant and an exposed recipient kidney is definitely extremely extraordinary.The purpose of this case study is to showcase a patient who developed substantial necrosis of the skin of the abdominal wall following a Living unrelated Right Renal transplantation (LURRT) procedure in order to highlight the importance of protecting rectus abdominis perforator blood vessels in order to maintain skin vitality.Case Report: 67-year-old female presented with skin necrosis and exposed transplanted kidney.The patient has a history of End Stage Renal Disease, Crohn's disease, and secondary adrenal insufficiency.The patient underwent ileocecal resection and ileostomy creation.The patient underwent Living unrelated Right Renal transplantation (LURRT) with a complicated post-transplant course.The wound edges were refreshed and the wound base was curetted and irrigated with antibiotics.A mesh of Acellular Dermal Matrix (ADM) was placed over the exposed kindly covering it completely and two abdominal local flaps were advanced to close the defect.Conclusion: Kidney transplantation is the preferred treatment for end-stage renal disease over dialysis.Surgical site complications (SSCs) are a major cause of morbidity in kidney transplant recipients, so when making an abdominal incision, always consider the blood supply provided to surrounding structures, and keep the risk of compromising abdominal perforator blood vessels in mind.Thus, proper anatomical planning prior to surgery can aid in avoiding such a catastrophic outcome.