有茎腹直筋皮弁により腹壁再建を行った広範囲腹壁〓開の1例

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  • A CASE OF LARGE DEFECT OF THE ABDOMINAL WALL WITH INFECTION RECONSTRUCTED BY PEDICLED RECTUS MYOCUTANEOUS FLAP

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This paper presents a case of large defect extending to the full-thickness of the abdominal wall infection which was reconstructed by pedicled rectus myocutaneous flap, with a good result. A 63-year-old obese man, who underwent a colectomy for cancer of the descending colon, had stomal leakage and infectious wound of the abdominal wall. Then, the full-thickness abdominal wall had opened due to MRSA infection of the wound (12×8cm). We were very worried about the treatment, because case reports or literature describing any strategies and treatments for such large abdominal wall defect with infection were very few. We found a great deal of difficulty in primarily closing the abdominal wound due to severe obesity and several adhesions in the peritoneal cavity. Then closure of the wound by means of artificial materials was thought to make infectious status worse. The defect of the abdominal wall was successfully reconstructed with the myocutaneous flap using the abdominal rectus muscle. Reconstruction with the myocutaneous flap appears to be an effective method for closing the full-thickness abdominal wall defect.

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