# Double-Breasted Anterior Rectus Sheath Turnover Flap

## TL;DR

A new surgical technique called the DART flap is used to successfully close an open abdomen in a cancer patient, avoiding complications.

## Contribution

The DART flap is introduced as a novel, autologous method for early open abdomen closure.

## Key findings

- The DART flap enabled tension-free closure without fistula or bowel perforation.
- No hernia occurred during follow-up after using the DART flap.
- The flap is a simple and effective option for open abdomen management.

## Abstract

The management of the open abdomen follows wound management with temporary abdominal closure prior to definitive closure while concurrently managing patient nutrient and fluid losses. This case report describes the successful use of double-breasted anterior rectus sheath turnover (DART) flap for early open abdomen closure to facilitate oncological management. The patient is a 47-year-old female with uterine smooth muscle neoplasm whose laparotomy wound was complicated with abdominal wound dehiscence and intra-abdominal infection. The abdomen could be closed with no fistula formation, iatrogenic bowel perforations, or overlying skin necrosis, and a follow-up showed no hernia occurrence. In conclusion, the DART flap provides a simple and autologous option for early tension-free midline closure of the open abdomen with acceptable intra- and postoperative complications.