Reconstruction of Midline Abdominal Wall Defect with Muscle Partition

利用肌肉分割重建腹壁缺損

陳盈安(Ying-An Chen) ； 林承弘(Cheng-Hung Lin) ； 袁國慶(Kuo-Chin Yuan) ； 林志鴻(Chih-Hung Lin)

《中華民國整形外科醫學會雜誌》 18卷1期 (2009/03) Pp. 10-16

https://doi.org/10.7096/JPSA.200903.0010

摘要

背景
使用mesh來重建複雜的腹壁缺損常會造成一些合併症，其中又以腸皮膚廔管及mesh突出移位最為嚴重。
材料及方法
在1997至2007之間，我們利用肌肉分割重建六個病人的腹壁缺損，重建的缺損範圍由200(10×20)平方公分至450(15×30)平方公分。
結果
術後無重大併發症，重建後的腹壁亦能提供動態的功能。在追蹤15個月之後，皆沒有復發的情形。
結論
術前的評估非常重要，包括營養狀態及傷口的情況皆須審慎的考慮。儘管mesh的使用是目前腹壁重建的主流，我們認為利用肌肉分割重建腹壁缺損卻是更理想與安全的方法。

並列摘要

Background:
Closure of large abdominal-wall defects with mesh implantation may associate with complications including infection, seroma formation, bowel erosion, enterocutaneous fistula and loss of compliance of abdominal wall.
Materials and Methods:
Between 1997 and 2007, six patients underwent muscle partition for the
reconstruction of large abdominal-wall defect ranging from 200 (10×20) cm^2 to 450(15×30) cm^2 in our institution.
Results:
The post-operative courses were smooth without major complications except one patient expired due to septic shock related to repeat disruptions of intestinal anastomosis. No hernia occurred through repaired abdomen at 15 months follow-up.
Conclusion:
Preoperative evaluation including predisposing factors, nutrition status and wound bed condition is important. After well preparing, the management of large abdominalwall defect with muscle partition could achieve safe and successful functional outcomes.

並列關鍵字

abdominal wall defect ； muscle partition ； ventral hernia