Lantieri L A, Tantaoui B, Rimareix F A, Raulo Y F, Baruch J P
Department of Plastic and Reconstructive Surgery, Centre Hospitalo Universitaire Henri Mondor Assistance Publique Hopitaux de Paris, France.
Plast Reconstr Surg. 1999 Mar;103(3):960-3. doi: 10.1097/00006534-199903000-00029.
An alternative surgical treatment is proposed here for radionecrosis of the lower back. A 78-year-old patient was treated successfully for a nonhealing ulcer with a pedicled omental flap. The omentum was harvested endoscopically and brought out of abdominal cavity through a limited incision on lateral left side of abdominal wall. The omentum was then tunneled to the back for coverage the lower back. The combination of an endoscopic harvest of an omental flap performed by a general surgeon and wound debridement and skin grafting of the omentum by a plastic surgeon allows minimal donor-site morbidity and avoids the use of delicate microsurgical technique. Additionally, omentum is an ideal flap for the treatment of radionecrosis.
本文提出了一种治疗下背部放射性坏死的替代性手术方法。一名78岁患者因顽固性溃疡接受带蒂大网膜瓣移植治疗，手术成功。通过内镜获取大网膜，并经腹壁左侧有限切口引出腹腔。然后将大网膜经隧道转移至背部以覆盖下背部。由普通外科医生进行内镜下大网膜瓣获取，整形外科医生进行大网膜清创和植皮，这种联合操作可使供区发病率降至最低，并避免使用精细的显微外科技术。此外，大网膜是治疗放射性坏死的理想皮瓣。
