Daigeler A, Fansa H, Altmann S, Awiszus F, Schneider W
Klinik für Plastische, Wiederherstellungs- und Handchirurgie, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg.
Chirurg. 2004 Jun;75(6):609-14. doi: 10.1007/s00104-003-0794-4.
Large abdominal hernias or abdominal wall defects often require the use of prosthetic mesh, local tissue transposition or even distant muscle flaps for proper reconstruction of the abdominal wall. The disadvantages of meshes are well known. The use of muscle flaps is an appreciated alternative.
We present 12 cases with reconstruction of the abdominal wall using pedicled rectus femoris muscle flaps after tumor resections, incisional hernias, and infection. Follow up time ranged from 6 months to 4 years. Abdominal wall stability was examined clinically. The aesthetic and the functional result were assessed using a standardized questionnaire. To objectively evaluate the loss of force in the quadriceps muscle the maximal voluntary knee extension torque was measured.
In all patients except one a stable abdominal wall was achieved. No major complications occurred. The loss of torque in the operated leg was tolerable.
The donor site morbidity is relatively low and the flap provides an easy and save possibility to reconstruct the abdominal wall. The rectus femoris muscle flap should be considered as an alternative for abdominal wall reconstruction.
大型腹部疝或腹壁缺损通常需要使用人工补片、局部组织移位甚至远处肌瓣来进行腹壁的适当重建。补片的缺点众所周知。使用肌瓣是一种值得赞赏的替代方法。
我们展示了12例在肿瘤切除、切口疝和感染后使用带蒂股直肌肌瓣重建腹壁的病例。随访时间为6个月至4年。临床检查腹壁稳定性。使用标准化问卷评估美学和功能结果。为了客观评估股四头肌的力量损失,测量了最大自主膝关节伸展扭矩。
除1例患者外,所有患者均实现了腹壁稳定。未发生重大并发症。手术侧下肢的扭矩损失是可以耐受的。
供区并发症相对较低,肌瓣为腹壁重建提供了一种简便且安全的方法。股直肌肌瓣应被视为腹壁重建的一种替代方法。