Ojika T, Mukoyama N, Suzuki M, Senda Y, Namiki Y
Department of Surgery, Nagoya Daini Redcross Hospital, Japan.
Kyobu Geka. 1995 May;48(5):394-6.
A rectus abdominis myocutaneous flap (RAM flap) has often been useful in breast reconstructions after the surgical therapy for breast cancer, or in other plastic surgeries. However, there have been few reports concerning about its applications for intrathoracic diseases. In this paper, we report two cases of recurrent empyema treated with RAM flap and muscle flap from rectus abdominis. One case is 75-year-old male with right-empyema and bronchial fistula after the thoracoplasty due to lung tuberculosis. The bronchial fistula was successfully closed with muscle flap from the right rectus abdominis. The other is 33-year-old male with left empyema and cutaneous fistula after the hemothorax due to traffic accident. He contracted with MRSA in his thoracic cavity. We resected the fistula and reconstructed his left chest wall with left RAM flap. The muscle flap from rectus abdominis or RAM flap has been very effective for the therapy of bronchial fistula after lung tuberculosis, and for the reconstruction of chest wall.
腹直肌肌皮瓣（RAM瓣）在乳腺癌手术治疗后的乳房重建或其他整形手术中常常很有用。然而，关于其在胸内疾病中的应用报道很少。在本文中，我们报告了两例用RAM瓣和腹直肌肌瓣治疗复发性脓胸的病例。一例是75岁男性，因肺结核行胸廓成形术后出现右脓胸和支气管瘘。用右腹直肌肌瓣成功闭合了支气管瘘。另一例是33岁男性，因交通事故致血胸后出现左脓胸和皮肤瘘。他胸腔内感染了耐甲氧西林金黄色葡萄球菌。我们切除了瘘管，并用左RAM瓣重建了他的左胸壁。腹直肌肌瓣或RAM瓣在治疗肺结核后的支气管瘘和胸壁重建方面非常有效。
