Diwakar Phuyal

Background Complex abdominal wall reconstruction (AWR) is a technically demanding procedure often required in patients with large fascial defects and significant comorbidities. When primary closure is not feasible, thigh-based flaps can provide durable soft tissue coverage and structural support. However, literature on flap-based AWR remains limited. Methods A retrospective cohort study of patients who underwent thigh-based AWR between 2014 and 2024 at a single tertiary center was conducted.

Conflicts of Interest The authors declare no conflicts of interest. Data Availability Statement The data that support the findings of this study are available from the corresponding author upon reasonable request. Supporting Information Filename Description micr70160-sup-0001-Supinfo.docxWord 2007 document , 80.5 KB Data S1: micr70160-sup-0001-Supinfo.docx. References , , , et al. 2018.

1 Introduction Ex situ machine perfusion (EVMP) has emerged over the past decades as a promising strategy to prolong organ viability and broaden the donor pool [1]. Normothermic machine perfusion supports near-physiologic metabolic activity and mitigates the damaging effects of cold ischemia and hypoxia, potentially preserving organ architecture and function while minimizing edema and cellular injury [2, 3].