Reconstruction of complex abdominal wall defects with pedicled anterolateral thigh flap

Year 2023, Volume: 6 Issue: 2, 345 - 349, 31.08.2023

Ömer Kokaçya , Damla Gencel

https://doi.org/10.36516/jocass.1342375

Abstract

Introduction: Traumatic abdominal injuries, surgical wound dehiscence, oncologic resections, transplant related complications or abdominal sepsis related visceral edema and abdominal compartment syndrome can cause enormous abdominal defects Abdominal defects are treated differently according to etiology and chronicity, size and thickness of the defect. ALT flap can be used pedicled or as a free flap for abdominal defect reconstruction.

Material and methods: Medical records of 8 patients who underwent pedicled ALT flap reconstruction of abdominal defects between August 2019 and November 2020 were retrospectively reviewed Demographic data, flap size, perforator number, complications, hospital stay, use of alloplastic mesh for fascia repair were recorded.

Results: 50% of patients received only 1 reconstructive operations while other 50% received more than one (min:2, max:4) operations. Total flap loss was seen at 12.5%. 25% of patients were lost due to non-flap related complications. Mean (min/max) hospital stay was 33,1 (12/90) days.

Conclusion: The pedicled ALT flap is a reliable and reproducible flap for reconstruction of abdominal defects without need for microsurgical vessel anastomosis. It has low donor and recipient site morbidity and potential complications can be easily managed with minor secondary operations.

Keywords

anterolateral thigh flap, abdominal defect, reconctruction

Kompleks Abdominal Duvar Defektlerinin Pediküllü Anterolateral Uyluk Flebi ile Onarımı

Abstract

Giriş: Abdominal defektler etiyolojilerine göre travmatik batın yaralanmaları, cerrahi bölgelerde sütür ayrışmaları, onkolojik rezeksiyonlar, transplant cerrahi sonrası komplikasyonlar veya abdominal kompartman sendromu gibi nedenlerle oluşmaktadır. Abdominal defektler, defektin etiyolojisine ve kronikliğine, boyutuna ve kalınlığına göre farklı şekilde tedavi edilir. ALT flebi abdominal defekt rekonstrüksiyonu hem pediküllü hem serbest flep olarak kullanılabilir.

Gereç ve yöntemler: Ağustos 2019 ve Kasım 2020 tarihleri arasında pediküllü ALT flebi ile abdominal defekt rekonstrüksiyonu yapılan 8 hastanın tıbbi kayıtları retrospektif olarak incelendi. Demografik veriler, flep boyutu, perforatör sayısı, komplikasyonlar, hastanede kalış süresi, fasya onarımı için alloplastik meş kullanımı kaydedildi.

Bulgular: Hastaların %50'si sadece bir tane rekonstrüktif ameliyat geçirirken, diğer %50'si birden fazla (min:2, maks:4) operasyon geçirdi. Total flep kaybı %12.5 olarak görüldü. Hastaların %25'i flep dışı komplikasyonlar nedeniyle kaybedildi. Ortalama (min/maks) hastanede kalış süresi 33,1 (12/90) gündü.

Sonuç: Pediküllü ALT flebi, mikrocerrahi damar anastomozuna ihtiyaç duyulmadan abdominal defektlerin rekonstrüksiyonu için kullanılabilecek güvenilir ve tekrarlanabilir bir fleptir. Verici ve alıcı bölge morbiditesi düşüktür ve olası komplikasyonlar küçük ikincil operasyonlarla kolayca yönetilebilir.

Keywords

antrolateral uyluk flebi, abdominal defekt, onarım

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