Ulus Travma Acil Cerrahi Derg. 2011; 17(3): 273-276 | DOI: 10.5505/tjtes.2011.32848

Kompleks inguinal defektlerin inferior epigastrik arterden kanlanan rektus abdominis kas flepleri ile rekonstrüksiyonu: Ýki olgu sunumu

Samet Vasfi Kuvat¹, Hakan Yanar², Ahmet Biçer³, Serdar Tunçer⁴, Burhan Özalp³, Murat Topalan^3
1Ýstanbul Eðitim Ve Araþtýrma Hastanesi, Plastik Ve Rekonstrüktif Cerrahi Kliniði
²Ýstanbul Týp Fakültesi, Genel Cerrahi Ana Bilim Dalý
³Ýstanbul Týp Fakültesi, Plastik Ve Rekonstrüktif Cerrahi Ana Bilim Dalý
⁴Bilim Üniversitesi, Týp Fakültesi, Plastik Ve Rekonstrüktif Cerrahi Ana Bilim Dalý

Brakiyal ve femoral arterler gibi tek vasküler kaynaðý olan ekstremitelerin damar ve çevresi yaralanmalarýnda, ekstremite kaybý gibi morbidite ya da kanama, sepsis ve vasküler uyuþmazlýða baðlý mortalite riski yüksektir. Ekspoze damar, kemik, tendon ve kýkýrdaklarý kapatacak komþu deri ve subkütan doku yetersizliði durumunda, bu bölgelerin rekonstrüksiyonunda ihtiyaç duyulabilen serbest mikrovasküler doku transferi, vasküler yaralanma sebebi ile beraberinde ek teknik zorluklarý da ortaya çýkarabilir. Bu koþullarda, pediküllü kas ve kas-deri flebi gibi rejyonel flepler (özellikle dolaþýmý iyi hacimli dokuya ihtiyaç varsa) alternatif olabilir. Bu yazýda, vasküler cerrahi kliniðince safen ven grefti ile femoral arter onarýmý sonrasý inferiora baze pediküllü rektus abdominis kasý ile rekonstrüksiyon uyguladýðýmýz iki olgu sunuldu.

Anahtar Kelimeler: Ýnguinal defekt, rektus abdominis kas flebi; vasküler yaralanma.

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Reconstruction of complex groin defects with inferior epigastric artery-based rectus abdominis muscle flaps: report of two cases

Samet Vasfi Kuvat¹, Hakan Yanar², Ahmet Biçer³, Serdar Tunçer⁴, Burhan Özalp³, Murat Topalan^3
1Istanbul Training And Research Hospital, Department Of Plastic And Reconstructive Surgery
²Istanbul Medical Faculty, Department Of Surgery
³Istanbul Medical Faculty, Department Of Plastic And Reconstructive Surgery
⁴Bilim University, Medical Faculty, Department Of Plastic And Reconstructive Surgery

Because the extremities are dependent on a single vascular supply, namely the brachial and femoral arteries, injuries around the girdles are challenging, and may contribute to high morbidity rates such as extremity loss, or even mortality due to bleeding, sepsis or vascular compromise. The reconstruction or aided closure of these regions may present additional technical difficulties in the presence of a vascular injury that complicates the use of a microvascular-free transfer, which sometimes may be needed to cover the exposed vessels, bones, tendons, and cartilages whenever the neighboring skin and subcutaneous tissue are inadequate or demised. In these circumstances, pedicled regional flaps of muscular or musculocutaneous consistency (especially if a bulk or rich vascular tissue is needed) would be an alternative. In this report, we present two cases that underwent femoral artery repair via saphenous vein grafting in the vascular surgery clinic followed by our inferiorly based pedicled rectus abdominis muscle flap coverage procedure.

Keywords: Groin defect, rectus abdominis muscle flap; vascular injury.

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