Clinical research of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds
10.3760/cma.j.cn114453-20200311-00135
- VernacularTitle:腹腔镜下切取大网膜游离移植联合植皮术修复下肢大面积难愈性创面
- Author:
Xiaofeng ZHANG
1
;
Aiwu WANG
;
Guiru YAN
;
Gang HU
;
Xudong CHEN
;
Qinghua XU
;
Juhui ZHAO
;
Hong WANG
;
Liliang ZHAO
Author Information
1. 汉中市中心医院医疗美容整形外科 723000
- Keywords:
Laparoscopes;
Omentum;
Autografts;
Free tissue flaps;
Skin transplantation;
Refractory wound
- From:
Chinese Journal of Plastic Surgery
2021;37(2):187-191
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.
