Kuzbari R, Worseg A P, Tairych G, Deutinger M, Kuderna C, Metz V, Zauner-Dungl A, Holle J
Department of Plastic Surgery at the Wilhelminen Hospital, University of Vienna Medical School, Austria.
Plast Reconstr Surg. 1998 Apr;101(5):1235-42. doi: 10.1097/00006534-199804050-00010.
We describe a technique that enables the autologous repair of large midline incisional hernias by restoring the functional musculoaponeurotic support of the abdominal wall. Unlike other methods of hernia repair, the essential step of the sliding door technique is the complete release of the rectus abdominis muscles from the anterior and posterior layers of their sheaths. The released muscles are thus overlapped and sutured together without tension. Another step of the technique is the release of both rectus sheaths by incising the aponeuroses of the external oblique muscles. We report on the use of this technique in 10 patients with midline incisional hernias (mean size of the abdominal musculofascial defect 14 x 11 cm). The patients were examined 14 months to 5.5 years after hernia repair. Two postoperative complications occurred: one marginal skin necrosis and one subcutaneous seroma. Recurrences were not observed. Ultrasound examination showed that the rectus muscles maintained their overlapped position postoperatively. Clinical muscle testing indicated that the strength of the released rectus muscles provides functional support to the reconstructed anterior abdominal wall.
我们描述了一种通过恢复腹壁功能性肌筋膜支撑来实现大型中线切口疝自体修复的技术。与其他疝修补方法不同，滑动门技术的关键步骤是将腹直肌从其鞘膜的前后层完全松解。这样松解后的肌肉相互重叠并无张力地缝合在一起。该技术的另一个步骤是通过切开腹外斜肌腱膜来松解双侧腹直肌鞘。我们报告了该技术在10例中线切口疝患者中的应用情况（腹部肌筋膜缺损平均大小为14×11厘米）。在疝修补术后14个月至5.5年对患者进行了检查。发生了2例术后并发症：1例边缘皮肤坏死和1例皮下血清肿。未观察到复发情况。超声检查显示腹直肌在术后保持了重叠位置。临床肌肉测试表明，松解后的腹直肌强度为重建的前腹壁提供了功能性支撑。
