腹直肌横向分割下腹穿孔器皮瓣提升术:包括一条以上穿孔器的拯救技术。

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-03-28 DOI:10.1002/micr.31169
Jong Yun Choi MD, Jun Nyeon Kim MD, Chae Rim Lee MD, PhD, Jangyoun Choi MD, PhD, Suk-Ho Moon MD, PhD, Young Joon Jun MD, PhD, Deuk Young Oh MD, PhD
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引用次数: 0

摘要

背景:为了增强下腹穿孔器(DIEP)皮瓣的血管功能,尽可能多地包含穿孔器非常重要。然而,必须横向横切直肌,这样就无法进行缝合,而且会造成与肌肉切除术相同的缺损。在采集 DIEP 皮瓣时,没有提出解决这些肌肉缺损的具体方法。我们发现,通过横向横切直肌,可以更容易地将肌肉缝合在肌腱区域,同时保持肌肉功能。本研究的目的是通过使用这种腱性横断和缝合方法进行 DIEP 皮瓣术后腹直肌的体积变化来证实腹直肌的长期恢复情况:对2018年5月至2020年4月期间使用DIEP皮瓣和多穿孔肌腱膜横切法进行单侧乳房重建的28例患者进行回顾性回顾。对收割侧和对侧的腹直肌的术前和术后体积进行了估算:收肌侧的术前和术后肌肉体积分别为(50.08±8.71)立方厘米和(48.56±8.61)立方厘米。体积差异为减少 1.522 立方厘米,无统计学意义(P = 0.070)。术前和术后对侧肌肉体积分别为 50.50 ± 8.15 立方厘米和 50.08 ± 8.18 立方厘米。体积差异为增加 0.434 立方厘米,无统计学意义(p = 0.064)。两侧直肌术后体积变化均无统计学意义:结论:DIEP 皮瓣手术中的肌腱横断法对术后直肌体积没有明显影响。因此,我们希望这种切取方法可用于包括多穿孔器和供体肌肉完全恢复的 DIEP 皮瓣重建。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transverse division of the rectus abdominis muscle in deep inferior epigastric perforator flap elevation: A rescue technique to include more than one perforator

Background

It is important to include as many perforators as possible in order to enhance the vascularity of a deep inferior epigastric perforator (DIEP) flap. However, the rectus muscle must be transected transversely, which prevents suturing and can cause a defect along the same line as the muscle-sparing procedure. When harvesting the DIEP flap, no specific method was suggested to solve these muscle defects. We found that by transecting the rectus muscle transversely, the muscle could be sutured in the tendinous area more easily while maintaining muscle function. The purpose of this study is to confirm the long-term recovery of the rectus abdominis muscle through the volume change after DIEP flap using this tendinous transection and suture method.

Patients and Methods

A retrospective review of 28 patients who underwent unilateral breast reconstruction using a DIEP flap and the tendinous transection method for multiple perforators between May 2018 and April 2020 was conducted. The preoperative and postoperative volumes of the rectus abdominis muscle were estimated both the harvest and opposite sides.

Results

The preoperative and postoperative muscle volumes from the harvest side were 50.08 ± 8.71 cm3 and 48.56 ± 8.61 cm3, respectively. The volume difference was 1.522 cm3 decrease, which was not statistically significant (p = .070). The preoperative and postoperative muscle volumes from the opposite side were 50.50 ± 8.15 cm3 and 50.08 ± 8.18 cm3, respectively. The volume difference was 0.434 cm3 increase and was not statistically significant (p = .064). Postoperative volume changes in the rectus muscle were not statistically significant on either side.

Conclusion

The tendinous transection method in the DIEP flap procedure did not significantly affect postoperative rectus muscle volume. Therefore, we expect this harvest method to allow DIEP flap reconstruction that includes multiple perforators and complete donor muscle recovery.

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来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
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