Closure of large lumbosacral defect using a combined method of bilateral bipedicle flap with lateral releasing incision and Integra® dermal regeneration template

Pauline Yap; Yap Pauline; Arman Zaharil Mat Saad; Mat Saad Arman Zaharil; Wan Azman Wan Sulaiman; Wan Sulaiman Wan Azman; Siti Fatimah Noor Mat Johar; Mat Johar Siti Fatimah Noor; Nurul Syazana Mohamad Shah; Mohamad Shah Nurul Syazana

doi:10.17816/PTORS71191

外侧释放切口双侧双蒂皮瓣结合Integra®真皮再生模板的大面积腰骶部缺损闭合术

作者: Yap P.¹^,2, Mat Saad A.²^,3, Wan Sulaiman W.², Mat Johar S.², Mohamad Shah N.²
隶属关系:
1. Universiti Malaysia Sabah
2. Universiti Sains Malaysia
3. Management and Science University
期: 卷 9, 编号 3 (2021)
页面: 345-351
栏目: Clinical cases
##submission.dateSubmitted##: 02.06.2021
##submission.dateAccepted##: 02.09.2021
##submission.datePublished##: 04.10.2021
URL: https://journals.eco-vector.com/turner/article/view/71191
DOI: https://doi.org/10.17816/PTORS71191
ID: 71191

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背景。脊髓脊膜膨出是一种最复杂的先天性中枢神经系统发育畸形，是脊柱裂最常见的类型之一，涉及神经管闭合失败。脊髓脊膜膨出重建手术对整形外科和神经外科来说一直是项挑战。

临床病例。我们报告了在本中心接受治疗的一例患腰骶部脊膜膨出的新生儿。脊髓脊膜膨出由神经外科团队修复，术后患儿遗留下大面积腰骶部皮肤缺损。我们采用经外侧释放切口的双侧双蒂皮瓣成功覆盖大面积缺损，剩余的腰骶部和继发性缺损采用Integra®真皮再生模板(DRT)进行修复。自体表皮移植创面床的准备过程中，使用ACTICOAT连接负压伤口治疗（NPWT）作为主要敷料。该闭合技术提供了无张力的闭合。

讨论。我们结合双侧双蒂筋膜皮瓣技术和DRT闭合腰骶部缺损。经外侧释放切口的双侧双蒂皮瓣可减轻双侧腰部皮肤张力。DRT缩小了腰骶部缺损，NPWT敷料提供了理想的无菌环境，为新生真皮形成提供时间。利用DRT和自体皮肤移植对剩余的继发性缺损进行修复。

结论。手术结果表明，外侧释放切口双侧双蒂筋膜皮瓣与DRT伴延迟植皮联用安全有效，并为大面积暴露硬膜缺损提供长期稳定的柔软疤痕。

关键词

脊髓脊膜膨出, 伤口闭合术, Integra, 腰骶部缺损, 真皮再生模板

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作者简介

Pauline Yap

Universiti Malaysia Sabah; Universiti Sains Malaysia

Email: paulineyap@live.com
ORCID iD: 0000-0002-2228-3473

马来西亚, Kota Kinabalu, Sabah; 16150 Kubang Kerian, Kelantan

Arman Zaharil Mat Saad

Universiti Sains Malaysia; Management and Science University

Email: armanzaharil@gmail.com
ORCID iD: 0000-0002-4003-6783

M.Sc., Professor

马来西亚, 16150 Kubang Kerian, Kelantan; Shah Alam, Selangor

Wan Azman Wan Sulaiman

Universiti Sains Malaysia

Email: wsazman@yahoo.com
ORCID iD: 0000-0002-0600-9765

M.Sc., Professor

马来西亚, 16150 Kubang Kerian, Kelantan

Siti Fatimah Noor Mat Johar

Universiti Sains Malaysia

Email: fatimahmj@usm.my
ORCID iD: 0000-0003-4120-4918

M.Sc.

马来西亚, 16150 Kubang Kerian, Kelantan

Nurul Syazana Mohamad Shah

Universiti Sains Malaysia

编辑信件的主要联系方式.
Email: syazanashah@usm.my
ORCID iD: 0000-0001-6731-9962

PhD

马来西亚, 16150 Kubang Kerian, Kelantan

参考

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