DISCUSSION
External oblique myocutaneous flap was used for the first time in the
1950s for the coverage of a lower abdominal wall
defect.3 Lately , the EOM flap has found its utility
in the closure of skin defects of the chest wall following radical
mastectomy and post-radiation necrosis.2 The EOM is
well vascularized as a type V muscle with both a single dominant blood
supply and multiple segmental supply. The dominant supply of the flap is
from the perforators arising from deep circumflex iliac artery, and the
segmental supply arises via perforators from 5th to
12th posterior intercostal
arteries.4
The harvest of EOM flap is technically easy and safe, as no major
neurovascular structures arise in the area of dissection. It can be done
in the supine position at the same setting. It allows for healing of
wound by primary intention and the donor site can be closed primarily.
Previous studies have mentioned successful coverage of skin defects upto
500 to 600 square cm.5 The largest defect filled in
our series was 528 square centimeter.
In Nepalese context wherein patients often present with advanced breast
cancer amidst a resource constrained environment, we have found the
utility of the EOM flap to be of paramount significance. It is
practical, straightforward and has consistently produced good results in
our small case series.