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Wang D, Zheng S, Qiu X, Fu Y. Immediate Repair With a Self-Gripping Retromuscular Mesh for Abdominal Wall Defect Following Tumor Resection. Surg Innov 2023; 30:50-55. [PMID: 35357985 DOI: 10.1177/15533506221087074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Prosthetic repair is always employed after large abdominal wall tumor resection, while chronic pain is one of the mesh-related complications after traumatic fixation. The objective of this research was to evaluate the outcomes of retromuscular repair with self-gripping mesh after abdominal wall tumor resection.Methods: The study was a monocentric retrospective analysis following STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statements of all patients with abdominal wall tumor >5 cm in diameter undergoing tumor excision and retromuscular repair with self-gripping mesh. Demographic, operative, early postoperative, and follow-up data were noted. Visual Analog Scale, ranging from 0 (no pain) to 10 (very severe pain), was used to estimate the wound pain.Results: 24 patients were included in this study, and the defect following tumor resection was 26.9±10.0 cm2. There was no tumor recurrence or incisional hernia in median follow-up of 20 months, and the mean VAS score was 0.4. Three had foreign body feeling and no one suffered chronic pain.Conclusions: Immediate repair with a self-gripping retromuscular mesh can be considered as an effective way to treat an abdominal wall defect after resecting an abdominal wall tumor.
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Affiliation(s)
- Dianchen Wang
- Department of Hernia and Abdominal Wall Surgery, 191599The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shouhua Zheng
- Department of Thyroid Surgery, 191599The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, China
| | - Xinguang Qiu
- Department of Thyroid Surgery, 191599The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, China
| | - Yang Fu
- Department of Hernia and Abdominal Wall Surgery, 191599The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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da Costa Vieira RA, de Oliveira-Junior I, Branquinho LI, Haikel RL, Ching AW. Modified External Oblique Myocutaneous Flap for Repair of Postmastectomy Defects in Locally Advanced Breast Tumors: A Cohort Series Associated with a Systematic Review of Literature. Ann Surg Oncol 2020; 28:3356-3364. [PMID: 33063264 DOI: 10.1245/s10434-020-09205-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Locally advanced breast tumors (LABT) are situations of difficult resolution in clinical practice. External oblique myocutaneous flap (EOMF) is an option, but there are few studies in the literature on its use. METHODS This was a retrospective, cohort institutional study of patients with LABT who were undergoing mastectomy combined with the use of modified-EOMF (M-EOMF). Preoperative indications and conditions, factors associated with surgery, time to radiotherapy, local recurrence, and survival were assessed. A systematic review of the literature also was performed to evaluate the use of EOMF. RESULTS Over the 10-year period, 17 patients underwent M-EOMF closure. The mean duration of surgery was 251 min, and extensive skin area was resected (mean 468 ± 260 cm2). Four patients developed local recurrence. The actuarial survival at 36 months was 48.3%. Using PRISMA statement, among 115 articles evaluated from 3 databases, 8 articles were selected, in which 146 patients underwent EOMF. EOMF are associated with low postoperative complications with 8.9% skin necrosis. The M-EOMF allowed the resection of larger areas than other flaps described in the literature but is associated with skin necrosis. CONCLUSIONS M-EOMF has the advantages of not requiring a change in the patient's position for the closure of large areas. It is thus an acceptable option for chest wall reconstruction in tumors at the limit of resectability.
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Affiliation(s)
- René Aloisio da Costa Vieira
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Barretos, SP, Brazil. .,Postgraduate Program Tocoginecology, Botucatu Medical School, Sao Paulo State University - UNESP, São Paulo, Brazil.
| | - Idam de Oliveira-Junior
- Postgraduate Program Tocoginecology, Botucatu Medical School, Sao Paulo State University - UNESP, São Paulo, Brazil.,Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, São Paulo, Brazil
| | | | - Raphael Luiz Haikel
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, São Paulo, Brazil
| | - An Wan Ching
- Department of Plastic Surgery, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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Salih AM, Kakamad FH, Najar KA, Mohammed KK, Mohammed DA, Mohammed SH. Covering a large abdominal wall defect using bilateral anterolateral myocutaneous thigh flap: A case report. Int J Surg Case Rep 2020; 75:261-263. [PMID: 32979822 PMCID: PMC7519278 DOI: 10.1016/j.ijscr.2020.09.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/28/2022] Open
Abstract
A variety of methods for abdominal wall closure have been described. Closure of a defect by myocuteous thigh flap is a viable option. In this report, bilateral anterolateral myocutaneous thigh flaps has been discussed.
Introduction Closure of the abdominal wall defect by myocuteous thigh flap is an option. The aim of this paper is to report a case of abdominal wall defect covered by bilateral anterolateral myocutaneous thigh flap. Case report A 45-year-old female presented with a large defect in the anterior abdominal wall. It was decided to cover the wound with bilateral anterolateral myocutaneous thigh flap as the defect was so large to be filled with a single flap. Under general anesthesia, a flap was elevated lateral to a line joining mid inguinal point to the lateral epicondyle, the flap was rotated under inguinal skin and sutured to the defect. The procedure was repeated for the contralateral side two weeks later. Discussion Lower abdominal wall defects can be reconstructed by the use of the combined technique of sublay technique, intraperitoneal mesh placement, pedicled great omentum flap and rotation skin graft, also tensor fascia lata has been proven to be a safe and versatile flap. Conclusion Bilateral anterolateral myocutaneous thigh flap is practical whenever indicated. It is best suited for covering of the lower abdominal defects.
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Affiliation(s)
- Abdulwahid M Salih
- College of Medicine, Department General Surgery, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq
| | - Fahmi H Kakamad
- Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq; College of Medicine, Department Cardiothoracic Surgery, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
| | - Kayhan A Najar
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Karukh K Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq; Raparin Laboratory, Newroz Street, Ranya, Kurdistan, Iraq
| | - Diyar A Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Shvan H Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
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Kumar N, Gupta D, Chattopadhyay D. External oblique muscle flap for abdominal wall reconstruction: Local solution for local problem. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2020. [DOI: 10.4103/ijawhs.ijawhs_1_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Boissière F, Luca-Pozner V, Vaysse C, Kerfant N, Herlin C, Chaput B. The SCIP propeller flap: Versatility for reconstruction of locoregional defect✰. J Plast Reconstr Aesthet Surg 2019; 72:1121-1128. [DOI: 10.1016/j.bjps.2019.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/10/2019] [Indexed: 10/27/2022]
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Sörelius K, Schiraldi L, Giordano S, Oranges CM, Raffoul W, DI Summa PG. Reconstructive Surgery of Inguinal Defects: A Systematic Literature Review of Surgical Etiology and Reconstructive Technique. In Vivo 2019; 33:1-9. [PMID: 30587595 DOI: 10.21873/invivo.11431] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to evaluate the literature regarding surgical etiology demanding inguinal reconstructive surgery, associated reconstructive techniques and outcomes. MATERIALS AND METHODS A systematic literature search was performed according to the PRISMA statement between 1996-2016. RESULTS A total of 64 articles were included, comprising 816 patients. Two main subgroups of patients were identified: Oncological resections (n=255, 31%), and vascular surgery (n=538, 66%). Oncological resection inguinal defects were treated with pedicled myocutaneous flaps (n=166, 65%), fasciocutaneous flaps (77, 31%), muscle flaps (7, 3%) and direct closure (3, 1%). Vascular surgery complications were treated with muscle flaps (n=513, 95%). Complications for the respective subgroup (oncological resections, vascular surgery) were: infection (24%, 14%), seroma (34%, 7.5%), flap dehiscence/delayed healing (20.6%, 40.8%,). The total reintervention rate was 20%. CONCLUSION Reconstruction of inguinal defects should be addressed on a case-by-case basis. Myocutaneous flaps were favoured after oncological resections, while muscle flaps were preferred after vascular surgery.
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Affiliation(s)
- Karl Sörelius
- Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden
| | - Luigi Schiraldi
- Department of Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Salvatore Giordano
- Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland
| | - Carlo M Oranges
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Wassim Raffoul
- Department of Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Pietro G DI Summa
- Department of Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Wang ZL, Wu SZ, Li ZF, Guo JH, Zhang Y, Pi JK, Hu JG, Yang XJ, Huang FG, Xie HQ. Comparison of small intestinal submucosa and polypropylene mesh for abdominal wall defect repair. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:663-682. [PMID: 29375018 DOI: 10.1080/09205063.2018.1433419] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Zhu-Le Wang
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Shi-Zhou Wu
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Zhi-Feng Li
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jin-Hai Guo
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
- Department of Orthopedics, Jin Tang Hospital, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Yi Zhang
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jin-Kui Pi
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jun-Gen Hu
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Xi-Jing Yang
- Animal Experimental Center, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Fu-Guo Huang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Hui-Qi Xie
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
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Wang CM, Zhang R, Luo P, Wu Z, Zheng B, Chen Y, Shi Y. Reconstruction of extensive thoracic wall defect using the external oblique myocutaneous flap: An analysis on 20 Chinese patients with locally advanced soft tissue sarcoma. J Surg Oncol 2017; 117:130-136. [DOI: 10.1002/jso.24823] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/10/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Chun-meng Wang
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Ruming Zhang
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Peng Luo
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Zhiqiang Wu
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Biqiang Zheng
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Yong Chen
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Yingqiang Shi
- Department of Bone and Soft Tissue Sarcomas; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
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Ji C, Li R, Shen G, Zhang J, Liang W. Multiple pedicled flaps cover for large defects following resection of malignant tumors with partition concept. Medicine (Baltimore) 2017; 96:e7455. [PMID: 28682914 PMCID: PMC5502187 DOI: 10.1097/md.0000000000007455] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Large defects after skin malignant tumors resection were difficult to repair. We introduced a partition concept, in which the large defects were divided into several subunits, and each subunit was repaired by a certain pedicled flap to achieve a complete coverage.Between May 2012 and Oct 2016, 8 patients with skin malignant tumors underwent radical resection. Prior to surgery, the dimension of the potential defect after tumor ablation was estimated and outlined. After evaluation, the partition concept was applied and the defects were divided into several subunits. Also, the rationality of the choice of pedicled flap was evaluated. Each flap was used to cover its specific subunits defect.After excision, the defect areas were from 13 × 17 cm to 36 × 23 cm. Each subunit was designed to be repaired with a pedicled flap, which included local random flap, superficial iliac artery flap, transverse rectus abdominis myocutaneous (TRAM) flap, lateral thoracic advanced island flap, anterolateral thigh (ALT) flap, anteromedial thigh (AMT) flap, and deep circumflex iliac artery (DCIA) flap. Primary closure of both donor and recipient sites was achieved in all patients. All the flaps survived. Flap necrosis was not observed.Reconstruction of large defects following resection of malignant tumors with multiple pedicled flaps was a reliable method. The partition concept is useful in the reconstruction of large tumor wounds in 1-stage operation.
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Vieira RADC, da Silva KMT, de Oliveira-Junior I, de Lima MA. ITADE flap after mastectomy for locally advanced breast cancer: A good choice for mid-sized defects of the chest wall, based on a systematic review of thoracoabdominal flaps. J Surg Oncol 2017; 115:949-958. [DOI: 10.1002/jso.24619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/02/2017] [Indexed: 12/15/2022]
Affiliation(s)
- René Aloisio da Costa Vieira
- Postgraduate Program in Oncology, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Katia Mathias Teixeira da Silva
- Postgraduate Program in Oncology, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Idam de Oliveira-Junior
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Marcos Alves de Lima
- Center of Epidemiology and Statistics, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
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Combined Use of Anterolateral Thigh and Gluteal Fold Flaps for Complex Groin Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e541. [PMID: 26579347 PMCID: PMC4634178 DOI: 10.1097/gox.0000000000000525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 09/01/2015] [Indexed: 11/27/2022]
Abstract
We present a case of an epithelioid sarcoma of the right groin in which wide resection resulted in a complex groin defect involving the full thickness of the abdominal wall and the perineum. We reconstructed the defect using a combination of pedicled anterolateral thigh (ALT) flap and gluteal fold flap. The functional and aesthetic results were satisfactory. The ALT flap with a robust iliotibial tract is the flap of choice for abdominal wall reconstruction; however, the area covered by the skin island of the flap is restricted because the skin island is tethered to the iliotibial tract. In such cases, a gluteal fold flap is ideal for an ALT flap. Therefore, using a combination of a pedicled ALT flap and a gluteal fold flap could be a reliable option for the reconstruction of a complex groin defect.
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