Gruen R L, Morrison W A, Vellar I D
Department of Surgery, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Aust N Z J Surg. 1998 Sep;68(9):666-9. doi: 10.1111/j.1445-2197.1998.tb04841.x.
The usual methods of closure of major chest and abdominal wall defects have significant disadvantages. Skin grafts provide no structural support and result in incisional hernias. Synthetic mesh requires skin cover and is prone to infection and wound breakdown. The tensor fasciae latae (TFL) myocutaneous flap offers skin cover and a semi-rigid fascial layer. We document our unit's experience in pedicled and free TFL flaps.
The TFL flap closure of trunk defects was undertaken in 10 patients between August 1989 and April 1997. All cases were not amenable to primary closure and repair with synthetic mesh or skin grafts.
The defect was satisfactorily repaired in all cases without subsequent herniation. The closure techniques using a pedicled TFL flap and a TFL flap for a free-tissue transfer are described.
We conclude that the TFL flap is the method of choice for repairs of major truncal defects.
胸部和腹壁大缺损的常用闭合方法存在明显缺点。皮肤移植无法提供结构支撑，会导致切口疝。合成网片需要皮肤覆盖，且容易感染和伤口裂开。阔筋膜张肌（TFL）肌皮瓣可提供皮肤覆盖和半刚性筋膜层。我们记录了本单位使用带蒂和游离TFL瓣的经验。
1989年8月至1997年4月期间，对10例患者采用TFL瓣闭合躯干缺损。所有病例均无法进行一期闭合以及用合成网片或皮肤移植进行修复。
所有病例的缺损均得到满意修复，无后续疝形成。描述了使用带蒂TFL瓣和TFL瓣进行游离组织移植的闭合技术。
我们得出结论，TFL瓣是修复躯干大缺损的首选方法。
