- 期刊
Simultaneous Island-pedicled Anterolateral Thigh Flap and Pedicled Tensor Fasciae Latae Flap for the Reconstruction of Abdominal Fascia Defect after Radical Ablation of a Recurrent Desmoid Tumor: A Ca
腹直肌處的硬纖維瘤切除後造成的腹筋膜缺損用擴筋膜張肌皮瓣及大腿前外側皮瓣重建－一個病例報告
摘要
我們報告一個生長在腹直肌處硬纖維瘤復發的病人，在切除後造成腹筋膜一個15×20平方公分的缺損，由於之前的手術用人造筋膜(Marlex)造成病人有疼痛的感覺且病人不想要有腹中線的明顯疤痕，我們用類似腹部拉皮的設計來切除復發腫瘤且計劃用擴筋膜張肌皮瓣來重建腹筋膜，為了徹底切除腫瘤，造成腹部傷口關閉時有張力，所以我們利用同側擴筋膜張肌皮瓣的傷口再拿了大腿前外側皮瓣同時做兩側腹筋膜的放鬆手術來重建腹筋膜及腹部傷口。 擴筋膜張肌皮瓣是下腹部筋膜重建的首選，而大腿前外側皮瓣可以作為一個救生艇，不管是筋膜不足或軟組織不夠都可以拿同側大腿前外側皮瓣，如此供皮瓣區的傷口只有一個，另外類似腹部拉皮的設計也讓術後的疤痕較不明顯。
關鍵字
無資料並列摘要
Aggressive fibromatosis, also known as desmoid tumor, was an uncommon, locally aggressive benign monoclonal fibroblastic proliferation arising in musculoaponeurotic structures. One 28 year-old female patient suffered from a recurrent desmoid tumor over lower abdominal wall. There was a 15×20 cm^2 abdominal fascia defect after radical ablation surgery. Combined island-pedicled anterolateral thigh (ALT) fasciocutaneous flap and pedicled tensor fasciae latae (TFL) flap were utilized to replace abdominal fascia and soft tissue defect. The whole course was smooth without any complication. The TFL flap is the prime choice of flap for middle and lower abdominal fascia defect reconstruction. The combination with the ALT flap might be the lifeboat for soft tissue and fascia insufficiency, and rendered limited donor site deformity. The obscure scar which may mimic that one in abdominoplasty is also the advantage by this design for radical excision of desmoid tumor. Simultaneous island-pedicled ALT flap and pedicled TFL flap have restored the abdominal wall both functionally and esthetically.
延伸閱讀
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