Sekido M, Yamamoto Y, Sugihara T, Nohira K, Shintomi Y
Department of Plastic and Reconstructive Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
J Reconstr Microsurg. 1996 Oct;12(7):425-30. doi: 10.1055/s-2007-1006614.
Microsurgical reconstruction of abdominal or chest-wall defects requires extreme precision but may still raise serious problems. In previous publications many methods have been reported, including free fascia graft, synthetic mesh, pedicled flap, and free flap with microvascular anastomoses. Free-flap transfer has become a popular operative procedure for such reconstructions. The recipient vessels utilized have been mainly the external peritoneal system. In some cases, however, it is very difficult to find adequate recipient vessels in the external peritoneal region. Intraperitoneal vessels may be obviously exposed in the surgical field because there has been a full-thickness defect of the abdominal or chest wall. These vessels are rather easily found and dissected. Their diameter is about 1 to 2 mm, appropriate for microvascular anastomoses with flap vessels in the reconstruction. Using intraperitoneal vessels for the recipient vessels has rarely been reported. The authors report three cases of reconstruction of full-thickness defects of the abdominal or chest wall, using these vessels as recipients for free flaps.
腹部或胸壁缺损的显微外科重建需要极高的精确度，但仍可能引发严重问题。在以往的文献中，已报道了许多方法，包括游离筋膜移植、合成网片、带蒂皮瓣以及微血管吻合的游离皮瓣。游离皮瓣移植已成为此类重建的常用手术方法。所使用的受区血管主要是腹膜外系统。然而，在某些情况下，很难在腹膜外区域找到合适的受区血管。由于存在腹部或胸壁的全层缺损，腹腔内血管可能在手术视野中明显暴露。这些血管相当容易找到并进行解剖。它们的直径约为1至2毫米，适合在重建中与皮瓣血管进行微血管吻合。使用腹腔内血管作为受区血管的情况鲜有报道。作者报告了3例使用这些血管作为游离皮瓣受区进行腹部或胸壁全层缺损重建的病例。
