Vargo Daniel
Department of Surgery, University of Utah, 30 North 1900 East, 3B-202 SOM, Salt Lake City, UT 84132, USA.
Am J Surg. 2004 Dec;188(6):633-7. doi: 10.1016/j.amjsurg.2004.08.051.
Abdominal compartment syndrome (ACS) and mesh implantation in abdominal wounds are creating abdominal wall problems not seen in the past. Component separation (CS) is an alternative technique used to manage these difficult wounds.
From January 2001 to July 2003, 27 patients were identified who had undergone CS. Charts were reviewed for defect etiology and characterization, surgical results, and outcome from reconstruction.
Etiology of the defect was ACS in 14, infected mesh in 5, and multiple failed repairs in 8 patients. Twenty-three were closed completely with CS, 2 required prosthetic mesh, and 2 had a porcine implant placed. Three wound complications occurred that required reoperation. Three hernia recurrences have been identified. All patients are completely recovered and are currently functioning without limitation.
Large and/or complex abdominal wall defects can be managed with a single-stage procedure using CS, thus many complications associated with implantation of prosthetic mesh are avoided. Functional outcome is excellent.
腹腔间隔室综合征（ACS）以及腹壁伤口植入补片正在引发过去未曾见过的腹壁问题。成分分离术（CS）是用于处理这些复杂伤口的一种替代技术。
2001年1月至2003年7月，确定了27例行成分分离术的患者。回顾病历以了解缺损病因及特征、手术结果和重建结局。
缺损病因是14例为腹腔间隔室综合征，5例为补片感染，8例为多次修复失败。23例通过成分分离术完全闭合，2例需要人工补片，2例植入了猪源植入物。发生了3例伤口并发症，需要再次手术。已发现3例疝复发。所有患者均已完全康复，目前功能不受限。
使用成分分离术的单阶段手术可处理大的和/或复杂的腹壁缺损，从而避免了与人工补片植入相关的许多并发症。功能结局极佳。
