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Rectus abdominalis musculocutaneous (RAM) flaps have numerous uses in the treatment of large defects. However, flap harvesting can result in abdominal wall incisional hernia and bulge, which are challenging problems. Most of these problems occur below the arcuate line abdominal wall. However, there will be differences that are unique to each patient in the area of hernia or bulge. The open approach repair appears to be used most often, but the precise area of hernia and bulge is often not distinguished. This report describes a case that was treated using a
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