Ulus Travma Acil Cerrahi Derg. 2014; 20(6): 443-451 | DOI: 10.5505/tjtes.2014.73478

Pediküllü rektus abdominis kas deri flebinin uyluk ve sýrt defektlerinde kullanýmý

Ahmet Duymaz¹, Furkan Erol Karabekmez², Mustafa Keskin^3
1Akademi Hastanesi Plastik, Rekonstrüktif Ve Estetik Cerrahi, Antakya Hatay
²Abant Ýzzet Baysal Ü. Týp Fak. Plastik, Rekonstrüktif Ve Estetik Cerrahi Ad., Bolu
³Ýstanbul Medipol Hastanesi, Plastik, Rekonstrüktif Ve Estetik Cerrahi, Koþuyolu Kadiköy Istanbul

AMAÇ: Daha önce tanýmlanmýþ, fakat az kullanýlan “ekstended” veya vertical rektus abdominis muskulokutan (“Ekstended” RAM, VRAM) fleplerinin çok nadir endikasyonlardaki kullanýmlarý incelendi.
GEREÇ VE YÖNTEM: Beþ hastada, 28x8 ile 35x10 cm ebatlarýnda cilt adasý içeren flepler kullanýldý. Dört flep uyluk ve diz proksimal bölgedeki defekt onarýmlarý için inguinal ligamentin altýndan, bir flep lomber gölgedeki defekt onarýmý için transabdominal olarak defekt alanlara taþýndý.
BULGULAR: Hiçbir olguda flep kaybý görülmedi. Bir olguda yara yeri enfeksiyonu geliþti ve cerrahi ile tedavi edildi. Uyluk ve lomber bölge defektleri onarýmlarýnda düþük komplikasyon oranlarýyla “ekstended” RAM ve VRAM fleple baþarýlý transfer gerçekleþtirildi ve çok güvenli ve uygun bir seçenek olduðu sunuldu.
SONUÇ: Avantajlarý bol miktarda ve iyi kanlanan doku taþýmasýný saðlar, flep kolay ve hýzlý hazýrlanýr ve mikrocerrahi deneyimi gerektirmez.

Anahtar Kelimeler: Pediküllü rektus abdominis kas deri flebi, uyluk ve sýrt defektleri.

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Using of Pedicled Rectus Abdominis Musculocutaneous Flaps in the Thigh and Lumber Defects

Ahmet Duymaz¹, Furkan Erol Karabekmez², Mustafa Keskin^3
1Akademi Hostpital, Department Of Plastic, Reconstructive And Aesthetic Surgery, Antakya Hatay
²Abant Izzet Baysal University, Faculty Of Medicine, Department Of Plastic, Reconstructive And Aesthetic Surgery, Bolu
³Istanbul Medipol Hostpital, Department Of Plastic, Reconstructive And Aesthetic Surgery, Kosuyolu Kadikoy Istanbul

A series of previously described but rarely used variation of the pedicled extended or vertical rectus abdominis musculocutaneous flap (Extended RAM, VRAM) was reviewed. Skin paddle dimensions ranged from 8 to 28 cm in width and from 10 to 35 cm in length in 5 consecutive patients. Four flaps were placed through deep to the inguinal ligament to repair the thigh as far as the proximal to the knee region; the remaining one flap was passed transabdominally to cover the defect of the lumbar region. No flaps necroses were seen, and one case wound healing problems required minimal operative intervention.
Successful transfer of the VRAM and extended RAM with low rate of complication for the thigh and lumbar region defects was demonstrated to be safe and reasonable option of flap reconstruction. The flaps had the advantages of being robust and a well vascularized flap, easy and fast to harvest, and not requiring microsurgery experience.

Keywords: Pedicled Rectus Abdominis Musculocutaneous Flaps, Thigh and Lumber Defects

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ATIF KOPYALA