Kearney Aaron M, Dumanian Gregory A
Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2020 Jul 15;8(7):e2970. doi: 10.1097/GOX.0000000000002970. eCollection 2020 Jul.
Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique.
We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications.
The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4-48.7 months).
Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.
创伤性腹壁疝是由钝性腹部创伤导致的罕见损伤。传统方法包括开放手术和腹腔镜手术，使用大尺寸补片并进行巨大重叠放置。这些修复手术在技术上最困难的方面可能是将腹壁固定到髂嵴上。资深作者开发了一种使用2厘米宽补片条的修复方法。在本文中，我们描述了4例采用该技术治疗的患者。
我们纳入了4例由资深作者进行创伤性侧腹壁疝修复的成年患者。我们排除了切口疝患者和接受平面补片的患者。收集的人口统计学和结果数据包括住院时间、随访时间和并发症。
平均年龄为38.5岁。3例疝是由机动车碰撞伤引起的，1例是工作时的挤压伤。未使用平面补片或骨锚。没有患者需要进行组织分离。没有发生手术部位感染、血肿或伤口裂开的情况。在最后一次随访时（平均24.3个月；范围4 - 48.7个月），所有修复均完好无损。
创伤性侧腹壁疝是罕见的损伤，可能难以处理。在此，我们描述了一种使用补片条进行一期修复的技术，该技术能将修复力分散到比缝合更大的表面积上。通过髂嵴钻孔避免了缝合锚钉的成本和复杂性。
