复杂放射性胸壁溃疡的多阶段皮瓣重建术
Multi-staged flap reconstruction for complex radiation thoracic ulcer.
作者信息
Valença-Filipe Rita, Horta Ricardo, Costa Joana, Carvalho Jorge, Martins Apolino, Silva Álvaro
机构信息
Department of Plastic, Reconstructive and Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Centro Hospitalar de São João, Porto University Medical School, Porto, Portugal.
Department of Plastic, Reconstructive and Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Centro Hospitalar de São João, Porto University Medical School, Porto, Portugal.
出版信息
Int J Surg Case Rep. 2014;5(12):1210-3. doi: 10.1016/j.ijscr.2014.11.041. Epub 2014 Nov 20.
INTRODUCTION
Chest wall reconstruction due to previous radiation therapy can be challenging and complex, requiring a multidisciplinary approach.
PRESENTATION OF CASE
The authors present the case of a 84-year-old woman with a right chest wall radionecrosis ulcer, that was submitted to an ablative surgery resulting in a full-thickness defect of 224cm(2), firstly reconstructed with a pedicled omental flap. Due to partial flap necrosis, other debridements and chest wall multi-staged flap reconstruction were performed.
DISCUSSION
This case highlights that the reconstructive choice should be individualized and dependent on patient and local factors. The authors advise that surgical team should work closely and be well versed in chest wall reconstruction with a variety of pedicled flaps, when a complication occurs.
CONCLUSION
A multi-staged flap reconstruction could be a salvage procedure for the coverage of complex, great and complicated chest wall defects due to previous radiation therapy.
引言
既往放疗后胸壁重建具有挑战性且复杂，需要多学科方法。
病例介绍
作者报告了一例84岁女性，患有右胸壁放射性坏死溃疡，接受了切除手术，导致224平方厘米的全层缺损，首先用带蒂网膜瓣进行重建。由于部分瓣坏死，进行了其他清创术和胸壁多阶段瓣重建。
讨论
该病例强调重建选择应个体化，并取决于患者和局部因素。作者建议，当出现并发症时，手术团队应密切合作，并精通使用各种带蒂瓣进行胸壁重建。
结论
多阶段瓣重建可能是一种挽救性手术，用于覆盖既往放疗导致的复杂、巨大和复杂胸壁缺损。
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