Staszewicz Wojciech, Assalino Michela, Morel Philippe, Fasel Jean H D, Stimec Bojan V, Tobalem Mickael
Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
Plast Reconstr Surg Glob Open. 2016 Dec 20;4(12):e1153. doi: 10.1097/GOX.0000000000001153. eCollection 2016 Dec.
In this cadaveric study, we explored the feasibility of a maximal mobilization of the superficial abdominal fascia, in a continuous flap, to achieve a tension-free covering of midline defects. The aponeurosis of the external oblique muscle was incised along the anterior axillary line and then detached up to the anterior rectus sheath. The latter was opened between the external and the internal oblique aponeurosis while keeping the continuity with the external oblique fascia. The obtained flap was solid and uninterrupted. The width gain reached 15 ± 3 cm on each sides, providing tissue advancement 60% longer than Ramirez's technique (n = 8). The described technique allows large covering with respect to the anatomical planes. Further clinical tests should evaluate the validity of such concept in the repair of giant and asymmetrical hernias.
在这项尸体研究中，我们探讨了将腹前壁浅筋膜最大限度地整块游离，以实现无张力覆盖中线缺损的可行性。沿腋前线切开腹外斜肌腱膜，然后向上游离至腹直肌前鞘。在腹外斜肌腱膜和腹内斜肌腱膜之间打开腹直肌前鞘，同时保持与腹外斜筋膜的连续性。所获得的皮瓣完整且不间断。每侧宽度增加达15±3cm，组织推进长度比拉米雷斯技术长60%（n = 8）。所描述的技术在解剖层面上允许大面积覆盖。进一步的临床试验应评估这一概念在修复巨大和不对称疝方面的有效性。
