Die M. latissimus dorsi-Lappenplastik – Salvage-Option bei der komplizierten Rezidiv-Narbenhernie

 

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Zusammenfassung

Komplizierte Narbenhernien stellen für den Patienten eine erhebliche Belastung und für den Chirurgen oft eine Herausforderung dar. In der Versorgung solcher Befunde besteht häufig ein Hauptproblem in der Defektdeckung, nachdem minderwertiges Gewebe großflächig reseziert werden muss. Wir beschreiben 2 Patienten, bei denen durch das komplexe Konzept einer primären Deckung mittels M. latissimus dorsi-Lappenplastik die tragfähige chirurgische Versorgung eines problematischen Ausgangsbefundes möglich war. Die Hernienreparation auf Faszien­niveau erfolgte dabei mittels Rinderperikard (Tutomesh^®).

Abstract

Complex incisional hernias are a serious burden for the patient and a challenge for the surgeon. The main problem is the covering of the defect after the resection of large proportions of low-grade tissue. In this work, we describe 2 patients who underwent complex reconstruction of recurrent incisional hernias using a bovine pericardium mesh (Tutomesh^®) and a latissimus dorsi myocutaneous free flap.··

• Literatur

• 1 Ventral Hernia Working Group . Breuing K, Butler CE, Ferzoco S et al. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010; 148: 544-558
  CrossrefPubMedGoogle Scholar
• 2 Conze J, Binnebösel M, Junge K et al. Incisional hernia – how do I do it? Standard surgical approach. Chirurg 2010; 81: 192-200
  CrossrefPubMedGoogle Scholar
• 3 Dietz UA, Spor L, Germer C-T. Management of mesh-related infections. Chirurg 2011; 82: 208-217
  CrossrefPubMedGoogle Scholar
• 4 Kisielinski K, Bertram P, Conze J et al. Management of gigantic recurrent incisional hernia. Repair by modified Ramirez component separation technique and a skin sliding flap. Chirurg 2004; 75: 529-532
  CrossrefPubMedGoogle Scholar
• 5 Durrant CAT, Khatib M, Macneill F et al. Mastectomy and reconstruction in stage IV breast cancer: A survey of UK breast and plastic surgeons. Breast 2011; 20: 373-379
  CrossrefPubMedGoogle Scholar
• 6 Pacella SJ, Vogel JE, Locke MB et al. Aesthetic and technical refinements in latissimus dorsi implant breast reconstruction: a 15-year experience. Aesthet Surg J 2011; 31: 190-199
  CrossrefPubMedGoogle Scholar
• 7 Button J, Scott J, Taghizadeh R et al. Shoulder function following autologous latissimus dorsi breast reconstruction. A prospective three year observational study comparing quilting and non-quilting donor site techniques. J Plast Reconstr Aesthet Surg 2010; 63: 1505-1512
  CrossrefPubMedGoogle Scholar
• 8 Harpf C, Ninkovic M, Kronberger P et al. Dynamic and functional abdominal wall stabilization, reconstruction of extensive abdominal wall defects. Chirurg 1997; 68: 488-492
  CrossrefPubMedGoogle Scholar
• 9 Langer S, Munder B, Seidenstuecker K et al. Development of a surgical algorithm and optimized management of complications – based on a review of 706 abdominal free flaps for breast reconstruction. Med Sci Monit 2010; 16: CR518-CR522
  PubMedGoogle Scholar
• 10 Limpert JN, Desai AR, Kumpf AL et al. Repair of abdominal wall defects with bovine pericardium. Am J Surg 2009; 198: e60-e65
  CrossrefPubMedGoogle Scholar