İNGUİNAL BÖLGEDE MUSKULOKUTANÖZ ANTEROLATERAL UYLUK (ALU) ADA FLEBİ İLE REKONSTRÜKSİYON

Yıl 2006, Cilt: 14 Sayı: 3, 200 - 206, 01.12.2006

Ufuk Bilkay Gökhan Temiz Cüneyt Özek Yalçın Akın

Öz

İnguinal bölgede bulunan kompleks yumuşak doku defektlerinin kapatılması plastik cerrahide sık karşılaşılan sorunlardan biridir. Söz konusu defektlerin kapatılmasında gövdeden taşınan fleplerin çeşitli nedenlerle kullanılamaması bu bölgenin rekonstrüksiyonunu güçleştirmektedir. İnguinal bölgede gövdeden flep taşınmasının mümkün olmadığı kompleks yumuşak doku defektine sahip iki hastada muskulokutanöz anterolateral uyluk (ALU) ada flebi ile rekonstrüksiyon uygulandı. Hastaların takibinde primer olarak flepten kaynaklanan ya da donör sahayı ilgilendiren bir problem yaşanmadı. Söz konusu flep inguinal bölgenin rekonstrüksiyonunda kolaylıkla kulanılabilecek, donör saha morbiditesi çok düşük olan, muskulokutanöz ya da kutanöz olarak planlanabilen bir cerrahi prosedür olarak öncelikle düşünülmelidir.

Anahtar Kelimeler

İnguinal bölge, ALU Flebi, Rekonstrüksiyon

Kaynakça

• Abraham V, Ravi R, Shrivasatava BR, Primary recnstruction to avoid wound brekdown following grion block dissection. Br.J Plast 45(3):211,1992.
• Bastwick J, Hill HL, Nahai F Repairs in the lower abdomen , groin or perneum with myocutaneus or omental flaps. Plast Rec Surg 63(2):372,1995.
• Santanelli F, Berlin O, Fodestam I. The combined tensör faciae latae/rectus femoris musculocutaneus flap:A possibility for major soft ttissue reconstruction in the grion , hip, gluteal, perineal, and lower abdominal regions. Ann Plast Surg 31(2)168,1993
• Lee, Michael J. M.D.; Dumanian, Gregory A. M.D. The Oblique Rectus Abdominis Musculocutaneous Flap: Revisited Clinical Applications. Plastic & Reconstructive Surgery. 114(2):367-373, August 2004
• Li-Ying Huang, M.D.,Hao Lin, M.D., Anterolateral Thigh Vastus Lateralis Myocutaneous Flap for VulvarReconstruction after Radical Vulvectomy: A Preliminary Experience.Gynecologic Oncology 78, 391- 393 (2000)
• Yu P, Sanger JR, Matloub HS, GosainA. Plast Reconstr Surg. Feb;109(2):610-616; discussion 617-618. 2002
• F. Demirkan, H.-C. Chen, F.-C. Wei, H.-H. Chen, S.-G. Jung, S.-P. Hau and C.-T. LiaoThe versatile anterolateral thigh flap: a musculocutaneous flap in disguise in head and neck reconstruction British Journal of Plastic Surgery (2000), 53, 30-36
• Stephan J. Mathes, Foad Nahaý; Anterior Lateral Thigh Flap; Reconstructýve Surgery Principles, Anatomy&Technique 1163-1173 1997
• Ramasastry SS, Ftrel JW, Williams SL, Hurwitz DJ, internal oblique muscule pedicle for coverage of major soft tissue defect of the groin. Ann plast surg 15(1):57,1985
• Bilkay U, Tokat C,Özek C,Çelik N,Gündoðan H,Gürler T, Alper M, Songür E. Vertikal rektus abdominis muskulokutan flebi ile kompleks yumþak doku yaralanmalarýnýn onarýmý. Türk plastik rekonstriktif ve estetik cerrahi dergisi Ocak- Nisan 10(1) 10-14 2002
• McCraw JB,Arnold PG vertical rektus. McCraw and Arnoldds atlas of muscule and musculekutaneous flaps. Hamton Pres Publiþh company, Inc, Norfolk Virginia 265,1986
• Graham, R. G., Omotoso, P. O., and Hudson, D. A. Theeffectiveness of muscle flaps for the treatment of prostheticgraft sepsis. Plast. Reconstr. Surg. 109: 108, 2002.
• Turnipseed, W. D., and Dibbell, D. G. Constructingmuscle flap coverage for vascular grafts in the groin.Semin. Vasc. Surg. 13: 62, 2000.
• Mathes, S. J., and Nahai, F. Reconstructive Surgery: Principles,Anatomy, Technique. New York: Churchill Livingstone, P. 1264. 1997.
• Amy S. Colwell, MD, Magruder C. Donaldson, MD, Michael Belkin, MD, and Dennis P. Orgill MD, PhD Management of Early Groin Vascular Bypass Graft Infections With Sartorius and Rectus Femoris Flaps Annals of Plastic Surgery o Volume 52, Number 1, January 2004
• McCraw, J. B., Massey, F. M., Shanklin, K. D., and Horton,C. E. Vaginal reconstruction with gracilis myocutaneousflaps. Plast. Reconstr. Surg. 58: 176, 1976.
• Heath, P. M., Woods, J. E., Podratz, K. C., et al. Gracilismyocutaneous vaginal reconstruction. Mayo Clin. Proc.59: 21, 1984.
• Joseph D. Alkon, M.D., Andrew Smith, M.D., Joseph E. Losee, M.D., Karl A. Illig, M.D., Richard M. Green, M.D., and Joseph M. Serletti, M.D. Management of Complex Groin Wounds:Preferred Use of the Rectus Femoris Muscle Flap Plast. Reconstr. Surg , March 776- 783 2005
• Caulfield, W. H., Curtsinger, L., Powell, G., and Pederson,W. C. Donor leg morbidity after pedicled rectusfemoris muscle flap transfer for abdominal wall andpelvic reconstruction. Ann. Plast. Surg. 32: 377, 1994.
• Dibbell, D. G., Jr., Mixter, R. C., and Dibbell, D. G., Sr.Abdominal wall reconstruction (the "mutton chop"flap). Plast. Reconstr. Surg. 87: 60, 1991.
• Scharf W. Anatomical and mechanical studies of the extensor system of the knee joint The Journal of Bone and Joint Surgery 82:1619 (2000)
• M. G. Benedetti, M.D. , F. Catani, M.D. , D. Donati, M.D. , L. Simoncini, M.D. and S. Giannini, M.D. Muscle Performance About the Knee Joint in Patients Who Had Distal Femoral Replacement After Resection of a Bone Tumor J Bone Joint Surg Am. Nov;82- A(11):1619-25. 2000
• Wilson, S. E. New alternatives in management of theinfected vascular prosthesis. Surg. Infect. 2: 171, 2001.
• Patel, A., Taylor, S. M., Langan, E. M., et al. Obturatorbypass: A classic approach for the treatment of contemporarygroin infection. Am. Surg. 68: 653, 2002.
• Graham, R. G., Omotoso, P. O., and Hudson, D. A. Theeffectiveness of muscle flaps for the treatment of prostheticgraft sepsis. Plast. Reconstr. Surg. 109: 108, 2002.
• Hallock, G. G. Identical rectus abdominis donor- sitemorbidity in compromised and healthy patients.J. Reconstr. Microsurg. 10: 339, 1994.
• Cherry, K. J., Roland, C. F., Pairolero, P. C., et al. Infectedfemorodistal bypass: Is graft removal mandatory J. Vasc. Surg. 15: 295, 1992.