Soots G, Mikati A, Warembourg H, Watel A, Noblet D
Service de Chirurgie Cardio-Vasculaire A, Hôpital Cardiologique de Lille, France.
J Cardiovasc Surg (Torino). 1988 Jan-Feb;29(1):42-5.
Thirteen myoplasties using the sartorius muscle were performed on 12 patients from 1980 to 1985 for "healing problems" in the groin with subjacent synthetic grafts. Persistant aseptic lymphorrhea was the indication for 4 patients. In 3 other cases, bacterial cultures from the wound were positive. In 2 other patients there was clinical evidence of sepsis with purulent discharge from the wound and an exposed graft. In 3 cases myoplasty was used as a preventive measure after reoperation on patients in poor general condition. Follow-up extends from 3 to 54 months. There was only one recurrence observed at 19 months which was successfully treated by segmental resection of the infected graft and insertion of a new prosthesis through the obturator canal. No recurrence was observed among the other patients as judged by clinical observation and biological tests for inflammation, echotomography, CT scan and indium scintigraphy. The treatment of choice for an infected prosthesis should be removal of the graft and extra-anatomic bypass in the majority of cases. However in some situations, excision of the wound and myoplasty using the sartorius muscle may be of some value and needs further evaluation.
1980年至1985年期间，对12例患者实施了13次使用缝匠肌的肌成形术，用于治疗腹股沟区伴有下方人工合成移植物的“愈合问题”。4例患者的手术指征为持续性无菌性淋巴漏。另外3例伤口细菌培养呈阳性。还有2例患者有脓毒症的临床证据，伤口有脓性分泌物且移植物外露。3例患者因全身状况较差再次手术后，肌成形术用作预防措施。随访时间为3至54个月。仅1例在19个月时复发，通过切除感染的移植物节段并经闭孔管植入新的假体成功治疗。根据临床观察以及炎症生物学检测、超声检查、CT扫描和铟闪烁扫描判断，其他患者均未复发。对于感染的假体，大多数情况下的首选治疗方法应是取出移植物并进行解剖外旁路手术。然而，在某些情况下，切除伤口并使用缝匠肌进行肌成形术可能具有一定价值，需要进一步评估。
