Kim Sang Wha, Han Sang Chul, Hwang Kyu Tae, Ahn Byung Kyu, Kim Jeong Tae, Kim Youn Hwan
Department of Plastic and Reconstructive Surgery, College of Medicine, Catholic University, Seoul, Korea.
ANZ J Surg. 2013 Dec;83(12):948-53. doi: 10.1111/j.1445-2197.2012.06286.x. Epub 2012 Sep 26.
Infected abdominal defects are a challenge to surgeons. In this study, we describe 10 cases in which the latissimus dorsi myocutaneous flap was used for successful reconstruction of abdominal wall defects severely infected with methicillin-resistant Staphylococcus aureus (MRSA).
Retrospective review of 10 patients with abdominal wall defects that were reconstructed using the latissimus dorsi myocutaneous flap between 2002 and 2010. All patients had abdominal defects with hernias, combined with MRSA infections. The sizes of the flaps ranged from 120 to 364 cm(2) . The deep inferior epigastric artery was the recipient vessel in nine patients and the internal mammary vessels were used for one patient.
There were no complications relating to the flaps, although there were other minor complications including wound dehiscence, haematoma and fluid correction. After reconstruction, there were no signs of infection during follow-up periods, and the patients were satisfied with the final results.
Reconstruction using the latissimus dorsi myocutaneous flap, including muscle fascia structures, is a potential treatment option for severely infected large abdominal wall defects.
感染性腹部缺损对外科医生来说是一项挑战。在本研究中,我们描述了10例使用背阔肌肌皮瓣成功重建严重感染耐甲氧西林金黄色葡萄球菌(MRSA)的腹壁缺损的病例。
回顾性分析2002年至2010年间10例使用背阔肌肌皮瓣重建腹壁缺损的患者。所有患者均有伴有疝的腹壁缺损,并合并MRSA感染。皮瓣面积从120至364平方厘米不等。9例患者以腹壁下深动脉为受区血管,1例患者使用胸廓内血管。
尽管存在伤口裂开、血肿和液体纠正等其他轻微并发症,但未出现与皮瓣相关的并发症。重建后,随访期间无感染迹象,患者对最终结果满意。
使用包括肌肉筋膜结构的背阔肌肌皮瓣进行重建,是严重感染的大型腹壁缺损的一种潜在治疗选择。