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VRAM steal syndrome ‐ a unique cause of flap necrosis in chest wall reconstruction

ABSTRACT The pedicled vertical rectus abdominis myocutaneous (VRAM) flap is a robust flap, which is considered to be a ‘workhorse' regional option for chest wall reconstruction. We describe a previously unreported complication of partial flap loss due to ‘steal syndrome', whereby arterial supply was diverted away from the flap due to dialysis from an ipsilateral arteriovenous fistula.