Khansa I, Janis J E
Department of Plastic Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Rd, Columbus, OH, 43212, USA.
Hernia. 2018 Apr;22(2):293-301. doi: 10.1007/s10029-017-1662-3. Epub 2017 Sep 4.
Open abdominal wall reconstruction is often a complex endeavor, usually performed on patients with multiple risk factors and co-morbidities.
In this article, we review soft tissue management techniques that can optimize the skin and subcutaneous tissue, with the goal of reducing surgical-site occurrences.
Regardless of the hernia repair technique used, outcomes can be highly dependent on the appropriate management of the skin and subcutaneous tissue. Indeed, dehiscence and surgical-site infection can jeopardize the entire reconstruction, especially in cases where synthetic mesh might become exposed and/or infected, setting up a "vicious cycle" (Holihan et al. in J Am Coll Surg 221:478-485, 2015).
Multidisciplinary cooperation between the general and plastic surgeon is useful in cases of tenuous blood supply to the abdominal skin, in cases of redundant, marginal or excessive skin, and in cases of deficient skin.
开放性腹壁重建通常是一项复杂的工作，通常在具有多种风险因素和合并症的患者身上进行。
在本文中，我们回顾了可优化皮肤和皮下组织的软组织处理技术，目标是减少手术部位并发症。
无论使用何种疝修补技术，结果都可能高度依赖于对皮肤和皮下组织的适当处理。事实上，伤口裂开和手术部位感染可能危及整个重建手术，特别是在合成补片可能外露和/或感染的情况下，从而形成一个“恶性循环”（霍利汉等人，《美国外科医师学会杂志》221:478 - 485，2015年）。
普通外科医生和整形外科医生之间的多学科合作，对于腹部皮肤血供薄弱、皮肤冗余、边缘性或过多以及皮肤缺损的病例是有用的。
