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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 378 -384. doi: 10.3877/cma.j.issn.1674-392X.2022.04.002

综述

自体组织瓣在腹壁缺损修复和重建中的应用
金华1, 叶静1, 王平1, 黄永刚1,†()   
  1. 1. 310006　浙江大学医学院附属杭州市第一人民医院疝和腹壁外科
  • 收稿日期:2022-04-03 出版日期:2022-08-18
  • 通信作者: 黄永刚
  • 基金资助:
    浙江省医药卫生科技计划项目(2021431768); 杭州市医药卫生科技项目(OO20191031)

Application of autologous tissue flap in abdominal wall defect repair and reconstruction

Hua Jin1, Jing Ye1, Ping Wang1, Yonggang Huang1,†()   

  1. 1. Department of Hernia and Abdominal Wall Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
  • Received:2022-04-03 Published:2022-08-18
  • Corresponding author: Yonggang Huang
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引用本文：

金华, 叶静, 王平, 黄永刚. 自体组织瓣在腹壁缺损修复和重建中的应用[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(04): 378-384.

Hua Jin, Jing Ye, Ping Wang, Yonggang Huang. Application of autologous tissue flap in abdominal wall defect repair and reconstruction[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(04): 378-384.

腹壁缺损修复和重建往往需要采用补片修补技术、组织结构分离技术及自体组织移植等多种技术，自体组织移植是其中最具挑战性的技术之一。由于相对较少的手术量和相应较弱的循证医学依据支持，自体组织移植技术在命名、分类和应用等方面仍缺乏统一标准。不同组织移植技术难度差异较大，基层医院开展困难。已经有较多的研究支持在自体组织移植的同时放置补片，但在可能污染或者污染的条件下是否放置补片以及放置何种类型补片仍存在争议。近年来，数字影像三维重建技术、3D打印技术及机器人手术等新技术逐步应用到组织移植和腹壁重建中，其效果值得进一步研究。同时也期待大样本、前瞻性的研究，为外科医师在腹壁缺损修复和重建过程中合理应用自体组织移植技术提供可靠依据。本文针对自体组织瓣在腹壁缺损修复和重建中的应用做简要综述。

关键词: 自体组织移植, 自体组织瓣, 腹壁缺损, 腹壁缺损修复, 腹壁重建

Abdominal wall defect repair and reconstruction commonly require the application of various techniques, including mesh repair technique, component separation technique, and autologous tissue transplantation. Autologous tissue transplantation is one of the most challenging techniques. Due to its low operation volume and shortage of high-level evidence, autologous tissue transplantation lacks unified standards in naming, surgical technology, perioperative management and curative effect evaluation; There is a big gap in the technical difficulty of different tissue flap transplantations, and it is difficult to carry out in primary hospitals; At present, quite a few studies have supported the placement of mesh at the same time as autologous tissue transplantation, but there are still disputes about whether to place mesh and what type of mesh to place in contaminated or infected environments; At present, digital three-dimensional image reconstruction techniques, 3D printing technology, robotic surgery and other new technologies have been gradually applied to autologous tissue transplantation and abdominal wall reconstruction, and their outcomes are worth further investigation. We look forward to a large sample size and prospective study to provide reliable evidence for clinicians to reasonably apply autologous tissue transplantation in abdominal wall defect repair and reconstruction. This paper reviews the application of autologous tissue flap in abdominal wall defect repair and reconstruction.

Key words: Autologous tissue transplantation, Autologous tissue flap, Abdominal wall defect, Abdominal wall defect repair, Abdominal wall reconstruction
表1 主要供区皮瓣名称及修复区域
供区位置 带蒂皮瓣名称 修复区域
腹部  腹直肌肌皮瓣 (SEA血管蒂) U+M1~2(上腹部)
  腹直肌肌皮瓣(DIEA血管蒂) L+M2~3(下腹部)
  腹外斜肌肌皮瓣 L
背部 背阔肌肌皮瓣 U+M1~2
股部 股前外侧肌皮瓣  
  股前内侧肌皮瓣  
  股外侧肌皮瓣 L+M2~3
  阔筋膜张肌肌皮瓣  
  股直肌肌皮瓣  
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