The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap.

IF 1 4区 医学 Q3 ORTHOPEDICS
Yumin Kim, Ji-Young Kim, Hak Chang
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引用次数: 0

Abstract

Background: Muscle sparing-transverse rectus abdominis flap has been widely used for breast reconstruction and the abdominal hernia or bulging at the donor site is relatively common complication. Previous studies have emphasized the fascial defects and the defect of muscle has been neglected. This study aims to investigate the relationship between the size of the rectus abdominis muscle defect and its impact on hernia or bulge formation after muscle sparing-transverse rectus abdominis flap.

Materials and methods: A retrospective study of patients undergoing unilateral or bilateral breast reconstruction with muscle sparing-transverse rectus abdominis myocutaneous flap was performed. We compared the patient group with postoperative abdominal hernia or bulging requiring surgery with the patient group without hernia. The surgical specific data of the size of rectus abdominis muscle defect, muscle sparing type and flap weight are analyzed.  Results: We conducted a survey on a total of 160 patients, of which six patients experienced abdominal hernia or bulging requiring surgery. Comparing patient group requiring surgical treatment for hernia or bulging with patient group without hernia, there was a significant difference of the width of rectus abdominis muscle defect. The cut-off value of the width was 4.5 cm.  Conclusion: When performing MS-TRAM, minimizing the resection of rectus abdominis muscle remains crucial, especially the horizontal width.

肌肉缺损大小对腹直肌横瓣术后供区疝和腹胀的影响。
背景:腹横直肌瓣在乳房再造术中应用广泛,供区腹疝或腹胀是较为常见的并发症。以往的研究多强调筋膜缺损,而忽略了肌肉缺损。本研究旨在探讨腹直肌缺损的大小及其对腹直肌横瓣留肌后疝或鼓包形成的影响。材料与方法:对单侧或双侧行保肌-腹直肌横断面肌皮瓣乳房再造术的患者进行回顾性研究。我们将术后有腹疝或腹胀需要手术的患者组与无疝的患者组进行比较。分析了腹直肌缺损大小、肌肉保留类型及皮瓣重量的手术特异性资料。结果:我们共对160例患者进行了调查,其中6例患者出现了腹疝或腹胀,需要手术治疗。需要手术治疗的疝或腹胀患者组与无疝患者组比较,腹直肌缺损宽度差异有统计学意义。宽度的临界值为4.5 cm。结论:在进行MS-TRAM手术时,尽量减少腹直肌的切除,尤其是水平宽度。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
108
审稿时长
6-12 weeks
期刊介绍: The purpose of the Journal of Plastic Surgery and Hand Surgery is to serve as an international forum for plastic surgery, hand surgery and related research. Interest is focused on original articles on basic research and clinical evaluation. The scope of the journal comprises: • Articles concerning operative methods and follow-up studies • Research articles on subjects related to plastic and hand surgery • Articles on cranio-maxillofacial surgery, including cleft lip and palate surgery. Extended issues are published occasionally, dealing with special topics such as microvascular surgery, craniofacial surgery, or burns. Supplements, usually doctoral theses, may also be published. The journal is published for the Acta Chirurgica Scandinavica society and sponsored by the Key Foundation, Sweden. The journal was previously published as Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.
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