Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Anticancer Res. 2019 Dec;39(12):6759-6768. doi: 10.21873/anticanres.13891.
BACKGROUND/AIM: Large full thickness abdominal wall defects following malignancies can be a reconstructive challenge. The purpose of this study was to analyze long-term outcomes and complications following abdominal wall reconstruction using composite antero-lateral thigh (ALT) flaps.
The study retrospectively investigated 16 consecutive patients who underwent abdominal wall reconstruction with autologous flap between May 2003 and March 2018. Volumetric flap analysis was used to assess flap atrophy over time, evaluating the role of denervation and reinnervation. The long-term outcome was assessed to compare the two groups (free vs. pedicled ALT flap reconstructions).
All flaps successfully covered the defects. We found a significant increase in flap resorption in free flaps when compared to pedicled ones. Abdominal bulging was seen in 3 out of 16 (19%) patients after more than 12 months follow-up, in close correlation with mesh absence.
Free flaps were shown to be equally effective as their pedicled counterparts, without significant increase in complication rate.
背景/目的:恶性肿瘤导致的大面积全层腹壁缺损是一种重建挑战。本研究旨在分析使用复合前外侧大腿(ALT)皮瓣进行腹壁重建的长期结果和并发症。
本研究回顾性调查了 2003 年 5 月至 2018 年 3 月期间接受自体皮瓣腹壁重建的 16 例连续患者。体积皮瓣分析用于评估随时间推移的皮瓣萎缩,评估去神经和再神经支配的作用。比较两组(游离 vs. 带蒂 ALT 皮瓣重建)的长期结果。
所有皮瓣均成功覆盖缺损。我们发现游离皮瓣的皮瓣吸收明显高于带蒂皮瓣。16 例患者中有 3 例(19%)在随访超过 12 个月后出现腹部膨出,与网片缺失密切相关。
游离皮瓣与带蒂皮瓣同样有效,并发症发生率无显著增加。