Dorai A A, Halim A S
Reconstructive Sciences Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Singapore Med J. 2007 May;48(5):e141-5.
Extensive full thickness anterior abdominal wall defects pose a difficult challenge to the reconstructive surgeon. The objectives of reconstruction are the support of the intra-abdominal structures in order to preserve the functional integrity and achieve an aesthetically-acceptable appearance. Autologous tissues are versatile and provide the best reconstructive option in this type of defects. The tensor fascia latae myocutaneous flap provides identical abdominal wall musculofascial cover for full thickness defects. In extensive defects, the extended tensor fascia latae flap is a versatile option with a second microvascular anastomosis at the distal end of the flap. A total anterior abdominal wall soft tissue tumour resection defect was reconstructed with the use of the double pedicle extended free tensor fascia latae myocutaneous flap in a 60-year-old man. The patient however succumbed to the disease process six months post-reconstruction. During the follow-up period, there was no evidence of hernia at the anterior abdominal wall.
广泛的全层腹壁缺损给重建外科医生带来了艰巨的挑战。重建的目标是支撑腹内结构,以保持功能完整性并实现美观的外观。自体组织用途广泛,是这类缺损的最佳重建选择。阔筋膜张肌肌皮瓣可为全层缺损提供相同的腹壁肌筋膜覆盖。在广泛缺损中,扩展阔筋膜张肌瓣是一种多功能选择,在瓣的远端有第二个微血管吻合。一名60岁男性因前腹壁软组织肿瘤行全切除术后缺损,采用双蒂游离扩展阔筋膜张肌肌皮瓣进行重建。然而,患者在重建后六个月死于疾病进展。在随访期间,前腹壁没有疝的迹象。