Barbosa Marcus Vinícius Jardini, Nahas Fábio Xerfan, Ferreira Lydia Masako
Morphofunctional Laboratory of the Scholl of Medicine of the University of Franca, Franca, São Paulo, Brazil.
Department of Surgery, Division of Plastic Surgery of the Federal University of São Paulo, São Paulo, Brazil.
Indian J Plast Surg. 2021 Oct 1;55(1):92-96. doi: 10.1055/s-0041-1735419. eCollection 2022 Feb.
The variation of the components' separation technique, which uses the anterior rectus sheath and the release of the oblique muscles, proved to be effective in tension reduction. This paper aimed to present the initial experience using a variation that preserves semilunaris through the incision of the lateral aspect of the rectus sheath. All of the 12 patients presented an abdominal wall defect that included incisional hernia, peritoneostomy, lateral implantation of the rectus muscle, and defect secondary to TRAM flap. The separation was done in the following stages: stage 1-anterior rectus sheath and stage 2-external oblique muscles. From the 12 patients, three presented early complications: seroma ( = 2) and epitheliolysis ( = 1). There were no recurrences or other late complications (48 months follow-up period). The separation of the anterior rectus sheath, and incision in the lateral recess to undermine the oblique muscles, allowed the treatment of abdominal wall defects, without late complications.
采用腹直肌前鞘和松解斜肌的成分分离技术的变异方法，在减轻张力方面被证明是有效的。本文旨在介绍通过腹直肌鞘外侧切口保留半月线的变异方法的初步经验。12例患者均存在腹壁缺损，包括切口疝、腹膜造口术、腹直肌外侧植入以及横行腹直肌肌皮瓣（TRAM瓣）继发缺损。分离按以下阶段进行：第1阶段——腹直肌前鞘，第2阶段——腹外斜肌。12例患者中有3例出现早期并发症：血清肿（n = 2）和表皮松解（n = 1）。无复发或其他晚期并发症（随访期48个月）。腹直肌前鞘的分离以及外侧隐窝的切口以松解斜肌，使得腹壁缺损得以治疗，且无晚期并发症。
