Persichetti Paolo, Simone Pierfranco, Scuderi Nicolò
Division of Plastic and Reconstructive Surgery, Campus Bio-Medico University, Rome, Italy.
Plast Reconstr Surg. 2005 Jul;116(1):289-94. doi: 10.1097/01.prs.0000170049.94288.d2.
Classic abdominoplasty leads to disappointing aesthetic results in patients with preexisting supraumbilical scars. Various techniques involving vertical and horizontal incisions have been described. The authors point out the validity of the "anchor-line" approach.
In a retrospective study, the authors reviewed the charts of 42 patients who underwent an anchor-line abdominoplasty between March of 1997 and March of 2003 at the Campus Bio-Medico University in Rome. The vascular anatomy of the abdominal wall was carefully reviewed, and they reported Huger's classification into three zones (zones I, II, and III). The third zone, which corresponds to the lateral areas of the abdomen, provides the vascular supply to the undermined abdominal wall flaps. Whenever this lateral vascularization is spared, there is no risk of skin necrosis. The anchor-line abdominoplasty implies the en bloc resection of a lower horizontal ellipsis plus an upper vertical triangle of abdominal skin and subcutaneous fat. The vertical triangle entails the supraumbilical scars. Plication of the rectus muscle sheath is always carried out.
Follow-up ranged from 1 to 5 years. The following complications were seen: seroma (n = 3), anemia (n = 2), infection (n = 1), and minor skin necrosis (n = 1).
The anchor-line technique, because of its easy execution, is a valid procedure in candidates for an abdominoplasty with supraumbilical median or paramedian scars.
经典腹壁成形术对于已有脐上瘢痕的患者而言,美学效果往往令人失望。已有多种涉及垂直和水平切口的技术被描述。作者指出了“锚线”法的有效性。
在一项回顾性研究中,作者回顾了1997年3月至2003年3月期间在罗马生物医学大学校园接受锚线腹壁成形术的42例患者的病历。仔细回顾了腹壁的血管解剖结构,并报告了休格将其分为三个区域(I区、II区和III区)。第三区对应于腹部外侧区域,为掀起的腹壁皮瓣提供血管供应。只要保留这种外侧血管化,就没有皮肤坏死的风险。锚线腹壁成形术意味着整块切除一个下部水平椭圆形加上一个上部垂直三角形的腹部皮肤和皮下脂肪。垂直三角形包含脐上瘢痕。总是要进行腹直肌鞘折叠术。
随访时间为1至5年。出现了以下并发症:血清肿(n = 3)、贫血(n = 2)、感染(n = 1)和轻微皮肤坏死(n = 1)。
锚线技术因其操作简便,对于有脐上正中或旁正中瘢痕的腹壁成形术候选者而言是一种有效的手术方法。