Ulus Travma Acil Cerrahi Derg. 2009; 15(5): 511-514

Serbest rektus abdominis kas filebi ile ayakta yumuþak doku rekonstrüksiyonu: Olgu sunumu

Serkan Yýldýrým
Lütfi Kýrdar Eðitim Ve Araþtýrma Hastanesi, Estetik, Plastik Ve Rekonstrüktif Cerrahi Kliniði,istanbul

Kompleks alt ekstremite yaralanmalarýnda, serbest flep uygulamalarý ile yumuþak doku defektlerinin tek seansta, iyi kanlanan bir doku ile ve baþarýlý bir þekilde rekonstrüksiyonu mümkün olmaktadýr. Yirmi dokuz yaþýnda erkek hasta, görev sýrasýnda mayýna basma sonucu, sol ayak özellikle de dýþ kýsýmda, ayak tabanýný da içerecek þekilde, kombine ve kirli bir yaralanma ile Sarýkamýþ Askeri Hastanesi acil servisine getirildi. Ýlk müdahalesi sonrasýnda geniþ debridman yapýlan hastada, mevcut doku defekti yaralanmadan bir hafta sonra serbest rektus abdominis kas flebi ve tam kalýnlýklý deri grefti ile örtüldü. Rekonstrüktif iþlemin baþarýlý olmasýyla, hastanýn ayaðý amputasyondan korundu ve günlük yaþantýsýna dönebildi. Bu olgu sunumunda, uygulama sýrasýnda karþýlaþýlan olan bir takým zorluklara deðinildi ve büyük þehirlerimizin dýþýndaki saðlýk merkezlerinde yapýlacak benzer uygulamalar için önerilerde bulunuldu.

Anahtar Kelimeler: Ayak rekonstrüksiyonu, rektus abdominis; serbest kas flebi.

---

Soft tissue reconstruction of the foot with free rectus abdominis muscle flap: case report

Serkan Yýldýrým
Department Of Aesthetic, Plastic And Reconstructive Surgery, Dr. Lütfi Kýrdar Training And Research Hospital, Istanbul, Turkey.

Major soft tissue defects of the foot usually require free tissue transfer for successful reconstruction. A 29-year-old man who injured his left foot in a mine explosion was admitted to Sarýkamýþ Military Hospital. Initial examination showed an extreme crush injury including soft tissue and bone structures of the lateral part of the foot. All necrotic tissues were extensively debrided and the soft tissue defect was reconstructed with a free rectus abdominis muscle flap and full thickness skin graft one week after the injury. The operation outcome was successful. After the rehabilitation period, the patient returned to a normal social life with minimal difficulties. The aims of this report were to alert reconstructive microsurgeons to the possible difficulties that can be encountered during free tissue transfer in small hospitals remote from city centers and to propose some possible solutions.

Keywords: Foot reconstruction, rectus abdominis; free muscle flap.

---

ATIF KOPYALA