Kovacević Predrag, Velickov Asen, Stojiljković Danilo, Velickov Aleksandra, Ceranić Zoran
Srp Arh Celok Lek. 2014 May-Jun;142(5-6):347-50. doi: 10.2298/sarh1406347k.
Reconstruction of a full thickness abdominal wall defect is a demanding procedure for general and also for plastic surgeons, requiring vigorous planning and reconstruction of three layers.
We present a case of a 70-year-old patient with a huge abdominal wall tumor with 40 years evolution. Surgery was performed under general anesthesia. Full thickness abdominal defect appeared after the tumor resection. Reconstruction followed in the same act. The defect was reconstructed using a combination of techniques, including omental flap, fascia lata graft, local skin flaps and skin grafts. After surgery no major complications were noted, only a partial skin flap loss, which was repaired using partial thickness skin grafts. The final result was described by the patient as very good, without hernia formation.
Omenthoplasty, abdominal wall reconstruction in combination with free fascia lata graft and skin grafts can be one of good options for the reconstruction of full thickness abdominal wall defects.
全层腹壁缺损的重建对于普通外科医生和整形外科医生来说都是一项具有挑战性的手术,需要精心规划并重建三层结构。
我们报告一例70岁患者,患有巨大腹壁肿瘤,病程长达40年。手术在全身麻醉下进行。肿瘤切除后出现全层腹壁缺损,并在同一手术中进行重建。采用多种技术联合重建缺损,包括大网膜瓣、阔筋膜移植、局部皮瓣和植皮。术后未出现重大并发症,仅部分皮瓣坏死,采用中厚植皮修复。患者称最终效果非常好,未形成疝。
大网膜成形术、联合游离阔筋膜移植和植皮的腹壁重建可成为全层腹壁缺损重建的良好选择之一。