Cerny M, Harder Y, Zimmermann A, Eckstein H-H, Machens H-G, Schantz J-T, Schenck T L
Klinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Ospedale Regionale di Lugano, Sede Italiano (OIL), Ente Ospedaliero Cantonale (EOC), Lugano, Schweiz.
Chirurg. 2017 Jan;88(1):43-49. doi: 10.1007/s00104-016-0244-8.
Vascular surgery through a groin incision may be associated with severe wound healing disorders in this sensitive area. There are many options to reconstruct the defect surgically. The choice of surgical reconstruction depends mainly on the individual status of vasculature, which is most often compromised in these patients. There are random pattern flaps, as well as perforator, pedicled flaps or microvascular flaps to choose from.
We give an overview of plastic surgical solutions for groin defects, with a special focus on complex wounds after vascular surgical complications. We discuss advantages and disadvantages of different flaps with two case reports and also show alternatives.
We demonstrate in two cases how the reconstruction of the groin defect was planned, taking into account the vascular status, and why we chose an innovative and seldom-used option in each case.
The selected flaps, a pedicled fasciocutaneous ALT propeller flap and a perforator-based, pedicled abdominal advancement flap reconstructed the defects successfully.
The surgical therapy for the reconstruction of groin defects should be chosen according to the individual vascular status to ensure safe and reliable blood supply. To guarantee the best possible reconstruction and avoid postoperative healing disorders and infections, less common flaps should also be considered.
通过腹股沟切口进行血管手术可能会在这个敏感区域引发严重的伤口愈合障碍。手术重建缺损有多种选择。手术重建方式的选择主要取决于血管的个体状况,而这些患者的血管状况往往受损。可供选择的有随意型皮瓣,以及穿支皮瓣、带蒂皮瓣或微血管皮瓣。
我们概述腹股沟缺损的整形手术解决方案,特别关注血管手术并发症后的复杂伤口。我们通过两个病例报告讨论不同皮瓣的优缺点,并展示替代方案。
我们在两个病例中展示了如何根据血管状况规划腹股沟缺损的重建,以及为何在每个病例中选择了创新且少用的方案。
所选皮瓣,即带蒂阔筋膜张肌肌皮推进皮瓣和基于穿支的带蒂腹部推进皮瓣成功重建了缺损。
腹股沟缺损重建的手术治疗应根据个体血管状况选择,以确保安全可靠的血液供应。为保证尽可能好的重建效果并避免术后愈合障碍和感染,也应考虑使用不太常用的皮瓣。