缝匠肌与股薄肌联合肌皮瓣修复下腹壁缺损

Reconstruction of the lower abdominal wall defects with the pedicled sartorius flap and gracilis flap

目的探讨应用缝匠肌与股薄肌肌皮瓣修复下腹壁缺损的方法。方法本组7例患者中腹壁恶性肿瘤切除术后5例，腹壁感染创面不愈合2例。采用缝匠肌与股薄肌联合肌皮瓣修复下腹部大面积软组织缺损。结果术后一期愈合6例，无切口裂开和切口疝形成，1例转位皮瓣有局部皮肤尖端坏死，经负压封闭引流、局部植皮处理后创面愈合。随访7例患者9～18个月，局部未见膨隆，无腹壁疝形成。结论缝匠肌与股薄肌联合肌皮瓣是修复下腹壁大面积软组织缺损的可靠方法。

Objective To evaluate the repair of lower abdominal wall defects with the pedicled sartorius flap and gracilis flap. Methods Among the 7 cases, 5 cases were of post malignant tumor resection within the abdominal wall, leaving huge defect. 2 cases of wound poor healing of the abdominal wall post-infection. Abdominal wall defects left over by tumor resection or debridement were repaired with the pedicled sartorius flap and graeilis flap. Results After the first phase of the operation, 6 cases were healed by first intention without incision infection, dehiscence or hernia formation. One case suffering initial flap tip necrosis was healed by VSD and skin grafting. All patients were followed up for 9 - 18 months. There was no swelling and no abdominal hernia. Conclusion It is reliable to repair abdominal wall defects with the pedicled sartorius flap and gracilis flap.