Germann G, Sauerbier M, Unglaub F
Klinik für Hand-, Plastische und Rekonstruktive Chirurgie--Schwerbrandverletztenzentrum--Berufsgenossenschaftliche Unfallklinik Ludwigshafen, 67071 Ludwigshafen.
Chirurg. 2006 May;77(5):424-31. doi: 10.1007/s00104-006-1183-6.
The anatomic characteristics of the anterior abdominal wall allow the harvesting of various types of flaps, some of them with considerable volume. These flaps are used mainly for reconstruction of the female breast, thoracic wall, and perineal or ilioinguinal region. Even though general donor site morbidity is low, hernias and "bulging" can occur due to the harvest of muscle and fascia, which leads to a weakening of the abdominal wall. Hernias and bulging appear mostly after harvest of classic flap types, which include removal of the rectus abdominis muscle. Further refinements of these flaps, i.e. microvascular flaps, in particular perforator flaps, lead to a marked reduction in donor site morbidity. In the following overview, the problem of abdominal wall weakening as a result of flap harvest is discussed and possible therapeutic options are elucidated.
腹壁前部的解剖学特征使得可以获取各种类型的皮瓣,其中一些皮瓣体积可观。这些皮瓣主要用于女性乳房、胸壁以及会阴或髂腹股沟区域的重建。尽管一般供区并发症发生率较低,但由于肌肉和筋膜的获取,可能会发生疝和“膨出”,这会导致腹壁变弱。疝和膨出大多出现在经典皮瓣类型(包括腹直肌切除)获取之后。这些皮瓣的进一步改进,即微血管皮瓣,尤其是穿支皮瓣,可显著降低供区并发症发生率。在以下综述中,将讨论因获取皮瓣导致腹壁变弱的问题,并阐明可能的治疗选择。