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不使用补片重建大面积腹壁缺损:一例报告。

Reconstruction of a large abdominal wall defect without using mesh: A case report.

作者信息

Rongviriyapanich Apinan

机构信息

Department of Surgery, Sisaket Hospital, Sisaket, 33000, Thailand.

出版信息

Int J Surg Case Rep. 2020;75:517-520. doi: 10.1016/j.ijscr.2020.09.125. Epub 2020 Sep 22.

Abstract

INTRODUCTION

Reconstruction of the abdominal wall supplemented by surgery of the abdominal wall infection or the excision of the abdominal wall tumor is one of the most difficult procedures due to the need to avoid incisional hernia and to minimize the spread of infection. The primary purpose of the repair of the abdominal wall is to safeguard the visceral organs and avoid postoperative incisional hernia. Many of the abdominal wall restoration procedures include simple sutures of rectus abdominis aponeurosis, component separation procedure, and open mesh repair. Mesh restoration is currently the gold standard in elective care for most instances of abdominal wall reconstruction.

PRESENTATION OF CASE

A male patient aged 69 years had cutaneous mucormycosis. We agreed to perform a wide excision of the lesion. There was a large abdominal wall defect after the excision. Due to concerns about mesh repair due to contaminated surgical area and loss of skin shielding, we opted to use Nylon Darn for abdominal closure.

DISCUSSION

We documented our technique for abdominal wall reconstruction using adapted Nylon darn.

CONCLUSION

For closing abdominal wall defects in surgical areas with elevated infection rates, the newly-designed technique proposed in this paper could be an alternative approach.

摘要

引言

由于需要避免切口疝并尽量减少感染扩散,腹壁重建辅以腹壁感染手术或腹壁肿瘤切除是最困难的手术之一。腹壁修复的主要目的是保护内脏器官并避免术后切口疝。许多腹壁修复手术包括腹直肌腱膜的简单缝合、成分分离手术和开放网片修复。目前,网片修复是大多数腹壁重建择期治疗的金标准。

病例介绍

一名69岁男性患者患有皮肤毛霉菌病。我们同意对病变进行广泛切除。切除后出现了一个大的腹壁缺损。由于担心手术区域污染和皮肤屏障丧失导致网片修复问题,我们选择使用尼龙织补法进行腹壁闭合。

讨论

我们记录了使用改良尼龙织补法进行腹壁重建的技术。

结论

对于感染率较高的手术区域的腹壁缺损闭合,本文提出的新设计技术可能是一种替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d18/7548985/c16212f63dc8/gr1.jpg

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