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吸脂术后腹壁重建成功:一例报告及文献综述

Successful Abdominal Wall Reconstruction Following Liposuction Catastrophe: A Case Report and Literature Review.

作者信息

Darras Osama, Yacoub Sara, Mordukhovich Isaac, Phuyal Diwakar, Woo Kimberly P, Rosen Michael J, Gurunian Raffi, Bishop Sarah N

机构信息

From the Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.

Department of General Surgery, Cleveland Clinic, Cleveland, OH.

出版信息

Ann Plast Surg. 2025 Aug 1;95(2):132-137. doi: 10.1097/SAP.0000000000004404. Epub 2025 May 5.

Abstract

BACKGROUND

Devastating abdominal injuries may result from liposuction, which can lead to necrotizing fasciitis and loss of abdominal domain. This may necessitate reconstructing the abdominal wall to improve the patient's quality of life.

OBJECTIVES

The study aims to raise awareness among the readers of this catastrophic complication. Guidelines for preoperative assessment, and intraoperative measures to reduce abdominal complications along with the importance of early recognition, diagnostic tools, and treatment strategies were provided.

METHODS

We reported a patient who underwent abdominal wall reconstruction following liposuction-inflicted abdominal injury and necrotizing fasciitis. Subsequently, a literature search was conducted to review abdominal wall reconstructive techniques following liposuction-inflicted abdominal injuries. Algorithms for patient safety followed this.

RESULTS

The patient developed necrotizing fasciitis due to liposuction cannula bowel perforation leading to loss of abdominal domain. This was reconstructed with a transversus abdominis release trial with mesh followed by bilateral pedicled neurotized anterolateral thigh flaps with vastus lateralis. The review of the literature included 10 papers describing different techniques of abdominal reconstruction. Common treatment techniques following liposuction-inflicted abdominal injuries were negative pressure wound therapy and skin grafting.

CONCLUSIONS

Anterolateral thigh flaps are an excellent option that provides functional and structural repair. Neurotization of the muscle helps protect the muscle from atrophy. The review of the literature showed a lack of abdominal wall reconstruction using musculocutaneous flaps following liposuction-inflicted abdominal injuries.Communicating symptom awareness to patients and the medical team is essential for quickly identifying potential visceral injury after liposuction, ensuring prompt management and improved outcomes.

摘要

背景

抽脂术可能导致严重的腹部损伤,进而引发坏死性筋膜炎并导致腹部区域缺失。这可能需要重建腹壁以提高患者的生活质量。

目的

本研究旨在提高读者对这种灾难性并发症的认识。提供了术前评估指南、减少腹部并发症的术中措施,以及早期识别、诊断工具和治疗策略的重要性。

方法

我们报告了一名患者,其在抽脂所致腹部损伤和坏死性筋膜炎后接受了腹壁重建。随后进行了文献检索,以回顾抽脂所致腹部损伤后的腹壁重建技术。并据此制定了患者安全算法。

结果

该患者因抽脂套管导致肠穿孔而发生坏死性筋膜炎,导致腹部区域缺失。采用带网片的腹横肌松解试验,随后使用双侧带蒂神经化股前外侧皮瓣加股外侧肌进行重建。文献综述包括10篇描述不同腹部重建技术的论文。抽脂所致腹部损伤后的常见治疗技术为负压伤口治疗和皮肤移植。

结论

股前外侧皮瓣是提供功能和结构修复的极佳选择。肌肉的神经化有助于保护肌肉免于萎缩。文献综述显示,抽脂所致腹部损伤后缺乏使用肌皮瓣进行腹壁重建的情况。向患者和医疗团队传达症状意识对于快速识别抽脂后潜在的内脏损伤、确保及时处理并改善预后至关重要。

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