Free Innervated Latissimus Dorsi Muscle Flap Transfer for the Reconstruction of a Traumatic Large Abdominal Wall Defect

具神經支配之闊背肌自由皮瓣轉移使用於外傷性大面積腹壁缺損之重建運用

莊家榮(Chia-Jueng Chuang) ； 陳錫根(Shyi-Gen Chen) ； 陳天牧(Tim-Mo Chen) ； 徐昌鴻(Chang-Hung Hsu) ； 王先震 (Hsian-Jenn Wang)

《中華民國整形外科醫學會雜誌》 10卷1期 (2001/03) Pp. 59-67

https://doi.org/10.7096/JPSA.200103.0011

摘要

大面積腹壁缺損之重建長久以來即為一臨床難題。儘管多種腹壁缺損修補手術已被運用，能夠提供動態腹部支持之具神經化肌肉皮瓣仍須被優先論證。我們提出一個因全層腹壁缺損成功的以具神經支配之闊背肌自由皮瓣作重建的病例。術後八個月之肌電圖顯示皮瓣有良好的復神經化反應。總結而言，具神經支配之闊背肌自由皮瓣可提供足夠之收縮力與強度來取代失去的腹壁肌肉，以達到適當且具動態功能性之腹壁缺損重建。

並列摘要

Reconstruction of massive abdominal wall defects has long been a difficult clinical problem. Despite various techniques for closure of large abdominal defects have been used, the superiority of innervated muscle flaps that provide dynamic abdominal support has to be demonstrated. We present a case with full-thickness abdominal wall defect successfully reconstructed with a free innervated latissimus dorsi(LD)muscle flap. Electromyographic evaluation at eight post-operative months demonstrated good reinnervation of the LD muscle flap. In conclusion, adequate functional dynamic reconstruction of abdominal wall defects could be possible in use of an innervated free latissimus dorsi muscle flap to offer enough contractile capacity and strength to replace the function of the missing abdominal wall muscles.

並列關鍵字

abdominal wall defect ； innervated muscle flap ； free LD muscle flap