血管假体感染后腹股沟缺损覆盖的整形外科管理与临床实践算法

IF 0.7 4区 医学 Q4 SURGERY
Irene Mesas Aranda, Konstantin Koban, Sinan Mert, Benedikt Fuchs, Riccardo Giunta, Severin Wiggenhauser
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引用次数: 0

摘要

腹股沟区血管假体感染是外科手术的一大挑战,与高发病率和死亡率相关。复杂的解剖结构和高密度的细菌定植相当复杂的手术处理。因此,重建治疗需要个性化和跨学科的策略来达到最佳效果。使用PubMed和Cochrane图书馆进行系统检索,收集和评估有关感染血管假体重建管理的现有证据和建议。所开发的算法结合了缺陷大小、感染严重程度和患者特异性特征等基本因素来指导治疗决策。带蒂皮瓣技术,特别是那些使用缝匠肌或股薄肌,是快速和可靠的重建解决方案-由于其强大的血管供应。在较大缺损的情况下,横肌股薄肌(TMG)、股直肌和股前外侧(ALT)皮瓣被证明是合适的选择。预防性使用带蒂皮瓣可减少术后并发症,特别是高危患者。深腹股沟感染的外科治疗需要细致的个体化和跨学科计划以及整形重建经验。提出的算法提供了一个结构化的、基于证据的框架,以提高治愈率并最大限度地降低并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Plastic Surgical Management and Clinical Practice-based Algorithm for Coverage of Inguinal Defects after Vascular Prosthesis Infection].

Infections involving vascular prostheses in the groin region are a major surgical challenge, associated with substantial morbidity and mortality rates. The complex anatomical structures and high density of bacterial colonisation considerably complicate their surgical management. Consequently, reconstructive therapy demands individualised and interdisciplinary strategies to achieve optimal outcomes.A systematic search was conducted using PubMed and the Cochrane Library to collect and evaluate current evidence and recommendations regarding the reconstructive management of infected vascular prostheses. The developed algorithm incorporated essential factors, such as defect size, infection severity, and patient-specific characteristics to guide therapeutic decision making.Pedicled flap techniques, particularly those employing the M. sartorius or M. gracilis, are rapid and reliable reconstructive solutions - due to their robust vascular supply. In cases of larger defects, the transverse myocutaneous gracilis (TMG), Rectus femoris, and anterolateral thigh (ALT) flaps proved to be suitable alternatives. Prophylactic use of pedicled flaps was associated with a reduction in postoperative complications, particularly in high-risk patientsThe surgical management of deep groin infection requires meticulous individualised and interdisciplinary planning and plastic reconstructive experience. The proposed algorithm provides a structured and evidence-based framework to improve healing rates and minimise the risk of complications.

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来源期刊
CiteScore
1.00
自引率
14.30%
发文量
116
审稿时长
6-12 weeks
期刊介绍: Konzentriertes Fachwissen aus Forschung und Praxis Das Zentralblatt für Chirurgie – alle Neuigkeiten aus der Allgemeinen, Viszeral-, Thorax- und Gefäßchirurgie.
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