改良双侧腹直肌推徙术治疗巨大计划性腹疝

Modified sliding myofascial flap of the rectus abdominus muscles for the closure of huge planned abdominal hernia

严重创伤后腹腔间隙综合征患者，需行腹腔扩容术。腹腔扩容术后部分患者不能行一期确定性关闭腹壁筋膜层，只能施行腹壁创面植皮术，从而形成计划性腹疝。随着时间延长，计划性腹疝的疝环进行性扩大，成为巨大腹壁切口疝。第三军医大学大坪医院野战外科研究所对1例巨大计划性腹疝患者施行改良双侧腹直肌推徙术，成功进行了确定性腹壁重建。实践证明该术式是一种安全、可靠的方法。

Abdominal increment is applied to patients with abdominal compartment syndrome （ACS） after severe trau- ma, while for some patients, intra-abdominal volume increment could not close the fascia within the primary stage. For theses patients, abdominal wound skin grafting was conducted, and the planned hernia was formed. Planned abdominal hernia developed over time, and finally huge incisional hernia was formed. This article described a modified sliding myofaseial flap of the rectus abdominus muscles for definitive abdominal wall reconstruction for a patient with huge planned abdominal hernia, and a good curative effect was obtained.