Avital Shmuel, Rosin Danny, Brasesco Oscar, Saber Alan A, Gupta Abhay, Boyd Brian, Rosenthal Raul J
Section of Minimally Invasive Surgery, Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
Ann Plast Surg. 2002 Sep;49(3):307-11. doi: 10.1097/00000637-200209000-00012.
The omentum is used for reconstruction of intra- and extra-abdominal wounds because of its high vascularity and immunological properties. It is used most often in patients in whom sternal wound infection develops after coronary artery bypass grafting. The major drawback of using the omentum is the necessity of performing a laparotomy to dissect and mobilize it to the thorax. The authors report their experience with an 81-year-old man, on whom they performed laparoscopic dissection and mobilization of the omentum, and transfer of the omentum based on its blood supply from the left gastroepiploic artery to reconstruct an infected sternal wound. The current literature is reviewed as well. The authors conclude that obtaining an omental flap via a laparoscopic approach is feasible and safe. It should be considered whenever an omental flap is needed outside the abdominal cavity. This approach mandates close collaboration between the plastic and the laparoscopic surgeons.
大网膜因其丰富的血管和免疫特性，被用于腹内和腹外伤口的重建。它最常用于冠状动脉搭桥术后发生胸骨伤口感染的患者。使用大网膜的主要缺点是需要进行剖腹手术来分离并将其转移至胸部。作者报告了他们对一名81岁男性患者的经验，他们对该患者进行了腹腔镜下大网膜的分离和转移，并基于其来自胃网膜左动脉的血供转移大网膜以重建感染的胸骨伤口。同时也对当前文献进行了综述。作者得出结论，通过腹腔镜途径获取大网膜瓣是可行且安全的。每当需要在腹腔外使用大网膜瓣时都应予以考虑。这种方法要求整形外科医生和腹腔镜外科医生密切协作。
