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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Intra-abdominal pedicled rectus abdominis muscle flap for treatment of high-output enterocutaneous fistulae: Case reports and review of literature
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Intra-abdominal pedicled rectus abdominis muscle flap for treatment of high-output enterocutaneous fistulae: Case reports and review of literature

机译：腹腔内蒂腹直肌肌皮瓣治疗高输出肠胃瘘：病例报告及文献复习

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摘要

Despite advances in nutritional supplementation, sepsis management, percutaneous drainage and surgical technique, enterocutaneous fistulae remain a considerable source of morbidity and mortality. Use of adjunctive modalities including negative pressure wound therapy and fibrin glue have been shown to improve the rapidity of fistula closure; however, the overall rate of closure remains poor. The challenge of managing chronic, high-output proximal enterocutaneous fistulae can be successfully achieved with appropriate medical management and intra-abdominal placement of pedicled rectus abdominis muscle flaps. We report two cases of recalcitrant high output enterocutaneous fistulae that were treated successfully with pedicled intra-abdominal rectus muscle flaps. Indications for pedicled intra-abdominal rectus muscle flaps include persistent patency despite a reasonable trial of non-operative intervention, failure of traditional operative interventions (serosal patch, Graham patch), and persistent electrolyte and nutritional abnormalities in the setting of a high-output fistula.
机译：尽管在营养补充，败血症处理，经皮引流和外科手术技术方面取得了进展，但肠内瘘仍然是发病率和死亡率的重要来源。辅助手段包括负压伤口治疗和纤维蛋白胶的使用已被证明可以改善瘘管闭合的速度。但是，总体关闭率仍然很差。通过适当的医疗管理和腹内带蒂腹直肌肌皮瓣的放置，可以成功解决管理慢性高产量近端肠皮内瘘的挑战。我们报告了两例顽固性高输出肠胃瘘，均已用带蒂腹内直肌肌皮瓣成功治疗。带蒂腹腔内直肌肌瓣的适应症包括尽管进行了非手术干预的合理试验，但仍持续通畅;传统手术干预（浆膜，格雷厄姆贴片）失败;以及高输出瘘口情况下持续的电解质和营养异常。

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