文章發表：Ann Plast Surg. 2010 Jan;64(1):65-8.
大綱
骨盆的肢體損傷可能併發膀胱破裂及下腹壁或會陰軟組織撕脫。撕脫的腹壁或會陰攣縮後，以及二次創傷或感染引起的膀胱組織損壞，直接縫合受傷的膀胱通常會導致縫合的張力過大，最終致缺血而修復失敗。作者使用根蒂股外側肌皮瓣成功治療了4例此類損傷的患者。沒有重大併發症發生且膀胱攝影證實膀胱完整及部分功能回復。其中三名（75％）能在1年內正常排尿。以此證明了根蒂股外側肌皮瓣是創傷後膀胱重建及下腹部或會陰軟組織覆蓋的理想選擇；肌肉表面下可以代替失去的膀胱壁，而其餘部分肌肉以及皮下脂肪則可以充填空腔提供足夠的體積。
Mutilating injury on pelvis may be complicated by urinary bladder ruptures and soft-tissue avulsion of the lower abdominal wall or perineum. With retraction of the avulsed abdominal wall or perineum, as well as bladder tissue loss secondary to trauma or infection, direct closure the injured bladder often leads to excessive tension, resulting in ischemia and eventual failure of repair. The authors successfully managed 4 patients with such injuries using the pedicled vastus lateralis myocutaneous flap. No major complications occurred and intact bladders were confirmed with cystograms. Three (75%) of them were able to void normally within 1 year. It is concluded that the pedicled vastus lateralis myocutaneous flap is an ideal option for posttraumatic bladder reconstruction and soft-tissue coverage of the lower abdomen or perineum; whereas the undersurface of the muscle serves as a substitute for the missing bladder wall, the remaining part of the muscle, as well as the subcutaneous fat, provide sufficient bulk for dead space obliteration.
Comments