Use of Tissue Expanders for Reconstruction of an Extensive Abdominal Wall Defect -A Case Report and Literature Review

腹內壓增高常引發一連串的腹部腔室症候群，包括肺部或腎臟衰竭等，這時便需執行減壓剖腹術治療，不過針對腹部腔室症候群所執行的減壓剖腹術常會留下大面積的腹壁缺損，使得後續的重建面臨了莫大的挑戰。面對這樣的挑戰，無論採取何種重建方式，原則上是以能夠儘可能的使腹壁恢復術前原貌（包括外觀、顏色、構造）及功能並減低相關併發症為其重建之目標。以往的做法是利用prosthetic mesh with split thickness skin graft來覆蓋腹壁缺損，但這樣的方式常帶有高感染率及相關併發症，不同於傳統的方式，本文發表了一個因壞死性胰臟炎併發腹部腔室症候群之病人於二週內成功地以組織擴張器重建其減壓剖腹術後之大面積腹壁缺損的例子，藉由組織擴張器的應用，使得腹壁得以被鄰近且具足夠良好血流的軟組織所覆蓋，同時也可以減低併發症的發生。此外我們也整理了相關的文獻報告。

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並列摘要

Laparotomies are indicated for patients suffering pulmonary or renal failure related to abdominal compartment syndrome. Large defects of the abdominal wall usually follow laparotomies that are associated with increased intraabdominal pressure. Therefore, primary closure of a large abdominal wall defect can be quite difficult or virtually impossible. Surgeons are guided by the desire to return the patient's abdominal wall, as much as possible, to its preoperative contour, texture and color. A method of accelerated delayed primary closure has been developed which leads to gradual expansion of the skin and subcutaneous tissue by means of the application of external tissue expanders. We report a successful closure of a huge abdominal wall defect for a case of necrotizing pancreatitis following a 14-day period of abdominal wall skin expansion by an implanted device. We also review the literature pertaining to the use of tissue expanders for the reconstruction of abdominal wall defects.

並列關鍵字

tissue expansion ； abdominal compartment syndrome ； abdominal wall reconstruction

國際替代計量

Use of Tissue Expanders for Reconstruction of an Extensive Abdominal Wall Defect -A Case Report and Literature Review

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