Alvedro-Ruiz Pedro, Sánchez-García Alberto, Heredia-Alcalde Iván, Andresen-Lorca Belén, Trapero-Ovejero Ana, Alonso-Carpio Miriam, García-Pastor Providencia, Pous-Serrano Salvador, Pérez-García Alberto
Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain.
Abdominal Wall Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain.
Indian J Plast Surg. 2024 Jul 4;57(Suppl 1):S111-S114. doi: 10.1055/s-0044-1788049. eCollection 2024 Dec.
Abdominal wall repair in adults with bladder exstrophy is challenging. We present a case of a 46-year-old woman with bladder exstrophy presenting with a large midline incisional hernia associated with a 13-cm hypoplasia of both pubic rami that precluded fixation of any abdominal mesh. A two-stage approach was adopted. First, a free vascularized osteocutaneous fibula flap was used to reconstruct the pelvic ring. After complete bone union 18 months later, a mesh was anchored to the fibula flap to restore the abdominal wall competence. After 2 years of follow-up, no hernia recurrence was observed, and the patient reported improved quality of life and self-esteem. This novel technique may provide long-term stability and good functional outcomes for reconstruction of the abdominal wall in selected adults with bladder exstrophy.
成人膀胱外翻患者的腹壁修复具有挑战性。我们报告一例46岁膀胱外翻女性病例，该患者伴有巨大的中线切口疝，双侧耻骨支发育不全13厘米，无法固定任何腹部补片。我们采用了两阶段手术方法。首先，使用游离带血管蒂腓骨骨皮瓣重建骨盆环。18个月后骨完全愈合，将补片固定于腓骨瓣上以恢复腹壁功能。经过2年随访，未观察到疝复发，患者报告生活质量和自尊有所改善。这种新技术可为特定的成人膀胱外翻患者腹壁重建提供长期稳定性和良好的功能结果。
