Bulic Kresimir, Dzepina Ivo, Mijatovic Davor, Unusic Josip
Department of Plastic Surgery, University Hospital Zagreb, 10000 Zagreb, Croatia.
J Plast Reconstr Aesthet Surg. 2008;61(4):455-8. doi: 10.1016/j.bjps.2007.03.034. Epub 2007 May 17.
Reconstruction of large, infected abdominal wall defects is often difficult. Local factors, such as defect size, presence of infection, adequate skin coverage and presence of enteric fistulae dictate the reconstructive method that can be used. Placement of prosthetic mesh materials into infected defects was generally not recommended due to a high rate of extrusion and fistulae. We present a patient with a large infected abdominal wall defect, exposed intestines and colostomy due to a gunshot wound that was successfully treated with a polypropylene mesh reinforcement and free latissimus dorsi muscle flap coverage. Twelve months following abdominal wall reconstruction with stable soft tissue cover, the patient is without any signs of hernia or infection. We conclude that prosthetic mesh repair of infected abdominal wall defects of such characteristics that preclude other reconstructive procedures can be attempted provided there is coverage with a well vascularised tissue.
大面积感染性腹壁缺损的重建往往具有挑战性。局部因素，如缺损大小、感染情况、是否有足够的皮肤覆盖以及肠瘘的存在，决定了可采用的重建方法。由于假体网片材料挤出和形成瘘管的发生率较高，通常不建议将其置于感染性缺损处。我们报告了一名因枪伤导致大面积感染性腹壁缺损、肠管外露和结肠造口的患者，通过聚丙烯网片加强和背阔肌游离肌皮瓣覆盖成功治愈。腹壁重建十二个月后，软组织覆盖稳定，患者无任何疝或感染迹象。我们得出结论，对于具有此类特征且排除其他重建手术可能性的感染性腹壁缺损，只要有血运丰富的组织覆盖，就可以尝试使用假体网片进行修复。
