Franco Mesa Camila, Mazzola Poli de Figueiredo Sergio, Lu Richard
Surgery, University of Texas Medical Branch, Galveston, USA.
Cureus. 2023 Feb 22;15(2):e35312. doi: 10.7759/cureus.35312. eCollection 2023 Feb.
Heterotopic ossification (HO) is an atypical complication of burn injuries presenting in 0.2-4% of cases. Usually, HO develops surrounding long bones or joints after orthopedic procedures or trauma. However, on extremely rare occasions, HO can develop from other bones such as the xiphoid. The purpose of this case report is to describe a case of an open retromuscular abdominal wall reconstruction with bilateral transversus abdominis release (TAR) in a patient with extensive abdominal heterotopic ossification following a midline laparotomy in the setting of a large burn injury. The patient was a 42-year-old man with a history of 55% total burn surface area (TBSA) second- and third-degree flame burns who was treated in a large academic hospital with a renowned burn unit. His case in particular was brought to attention for the rare presentation of the aftermath of a burn injury and the technical surgical challenge it posed. Five months after the last surgical intervention, the patient is doing well without further complications or clinical signs of hernia recurrence. Since there are no established guidelines for patients with HO after burn injuries, learning about alternate strategies will expand the armamentarium of abdominal wall reconstruction surgeons in this challenging patient population. Specifically, retromuscular ventral hernia repair with transversus abdominis release and synthetic mesh can be used in complex ventral hernia repair complicated by heterotopic ossification after a major burn.
异位骨化（HO）是烧伤后的一种非典型并发症，发生率为0.2%-4%。通常，HO在骨科手术或创伤后围绕长骨或关节形成。然而，在极少数情况下，HO可从剑突等其他骨骼形成。本病例报告的目的是描述一例在大面积烧伤后经正中剖腹手术后出现广泛腹部异位骨化的患者，行双侧腹横肌松解（TAR）的开放性肌后腹壁重建术。患者为一名42岁男性，有55%体表面积（TBSA）的二度和三度火焰烧伤史，在一家拥有著名烧伤科的大型学术医院接受治疗。他的病例尤其因烧伤后遗症的罕见表现及其带来的技术手术挑战而受到关注。最后一次手术干预五个月后，患者情况良好，无进一步并发症或疝复发的临床迹象。由于目前尚无针对烧伤后HO患者的既定指南，了解替代策略将扩大腹壁重建外科医生在这一具有挑战性患者群体中的治疗手段。具体而言，腹横肌松解联合合成补片的肌后腹疝修补术可用于大面积烧伤后并发异位骨化的复杂腹疝修补。
