随意型邻接皮瓣在腹壁全层缺失一期重建中的应用

Application of random adjacent flap in the one-stage reconstruction for a full-thickness loss of abdominal wall

目的探讨随意型皮瓣转移技术在腹壁全层缺失一期重建中的应用。方法回顾分析2005年4月至2012年3月南京医科大学第一附属医院,腹壁全层缺失采用随意型邻接皮瓣转移技术联合补片修补技术行腹壁一期重建11例患者的临床资料。结果 11例患者均完成了腹壁缺损的一期重建,临床效果满意。手术并发症主要是皮瓣坏死,其中1例因皮瓣坏死和补片感染,去除了一部分补片,术后2月死于全身衰竭。9例随访6～24个月,1例出现腹壁膨出,余无腹壁疝和补片感染发生。结论随意型邻接皮瓣转移覆盖皮肤缺损创面是一种操作简单、技术成熟和应用广泛的缺损修复技术,与补片腹壁修补技术结合,用于腹壁全层缺损的一期重建,操作简便,供区损伤小,修复效果好,值得推广。

Objective To investigate the application of the technique of random skin flap transposition for one-stage reconstruction of full thickness abdominal wall defect. Methods From April 2005 to March 2012, 11 cases of operation that applied the technique of random adjacent pedicle skin flap transposition combined with mesh repair for one-stage reconstruction of full thickness abdominal wall defect was retrospectively reviewed. Results Clinical effectiveness was satisfactory in spite of some complications. The main complication of operation included skin flap necrosis; in one case, part of mesh was removed due to skin flap necrosis and mesh infection. In addition, nine cases were followed up for 6 to 24 months, occurrence of abdominal bulge was observed in another case. No abdominal wall hernia or mesh infection was observed in other eases. Conclusions The technique of random adjacent skin flap transposition combined with mesh repair for one-stage reconstruction of full thickness abdominal wall defect is reliable and effective.