Boukovalas Stefanos, Sisk Geoffrey, Selber Jesse C
Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
Semin Plast Surg. 2018 Aug;32(3):107-119. doi: 10.1055/s-0038-1667062. Epub 2018 Jul 24.
Abdominal wall reconstruction has undergone substantial evolution over the last few decades. The optimal method of repair should be tailored to each patient's unique condition; however, a general approach that integrates four major factors can be applied as a conceptual framework to most clinical scenarios. Major factors to be considered include selection of mesh material, mesh inset position and technique, selective component separation, and management of soft tissue. These topics are inextricably intertwined in the sense that each can have specific implications, and in some cases, a determinative impact on the other decisions. When the relationship among these four factors is appreciated and applied to patient management, the reconstructive surgeon can achieve consistent outcomes that reflect skill, experience, and understanding.
在过去几十年里，腹壁重建技术有了长足的发展。修复的最佳方法应根据每个患者的独特情况量身定制；然而，一种综合四个主要因素的通用方法可以作为大多数临床情况的概念框架。需要考虑的主要因素包括网片材料的选择、网片植入位置和技术、选择性成分分离以及软组织的处理。这些主题紧密相连，因为每个主题都可能有特定的影响，在某些情况下，还会对其他决策产生决定性影响。当理解这四个因素之间的关系并将其应用于患者管理时，重建外科医生可以取得反映其技能、经验和理解的一致结果。
