带蒂大网膜瓣移植修复脑起搏器置入后继发排异创面的临床效果

管皓楠; 马先; 刘英开; 牛轶雯; 孙伯民; 唐佳俊; 陆树良

doi:10.3760/cma.j.cn501225-20220907-00396

带蒂大网膜瓣移植修复脑起搏器置入后继发排异创面的临床效果

doi: 10.3760/cma.j.cn501225-20220907-00396

1.
上海交通大学医学院附属瑞金医院创面修复中心，上海市创面修复研究中心，上海　200025
2.
上海交通大学医学院附属瑞金医院功能神经外科，上海　　200025

基金项目:

国家卫生计生委重大疾病防治科技行动计划创伤修复专项 2017ZX01001

详细信息

通讯作者:
陆树良，Email：13901738685@139.com

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出版历程
- 收稿日期: 2022-09-07

Clinical effects of pedicled omental flap transplantation in repairing secondary rejection wounds after brain pacemaker implantation

1.
Wound Repair Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Wound Repair Research Center, Shanghai 200025, China
2.
Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Funds:

Special Program for Trauma Repair of Science and Technology Action Plan of Major Disease Prevention and Treatment of National Health Committee of China 2017ZX01001

More Information

Corresponding author: Lu Shuliang, Email: 13901738685@139.com

摘要

摘要: 目的探讨采用带蒂大网膜瓣移植修复脑起搏器置入后继发排异创面的临床效果。方法采用回顾性观察性研究方法。2021年1—8月，上海交通大学医学院附属瑞金医院创面修复中心收治5例（男3例、女2例，年龄56~69岁）符合入选标准的置入脑起搏器后继发排异创面的患者，排异创面单纯位于胸前脉冲发生器置入部位者2例、单纯位于耳后导线与电极连接部位者2例、位于胸前+耳后者1例。所有排异创面均采用带蒂大网膜瓣移植修复。清创后创面面积为2~15 cm ²。术后，观察创面愈合情况以及相关并发症（疼痛、感染、切口疝、大网膜瓣坏死等）发生情况。随访时，观察创面有无复发情况。结果 5例患者创面均于术后2周内愈合，且未出现相关并发症。随访12~18个月，1例患者左侧耳后的排异创面在术后4个月复发，最终选择移除起搏器；其余4例患者创面无复发。结论采用带蒂大网膜瓣移植修复脑起搏器置入后的继发排异创面安全有效，术后并发症少。
- 帕金森病 /
- 炎症 /
- 脑起搏器 /
- 排异创面 /
- 创面修复 /
- 皮下囊袋 /
- 网膜
Abstract: Objective To explore the clinical effects of pedicled omental flap transplantation in repairing secondary rejection wounds after brain pacemaker implantation. Methods A retrospective observational study was conducted. From January to August 2021, 5 patients with secondary rejection wounds after brain pacemaker implantation who met the inclusion criteria were admitted to the Wound Repair Center of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine, including 3 males and 2 females, aged 56-69 years, with the wound developed at the pulse generator implantation site in the chest in 2 cases, at the connection site of the wire and electrode behind the ear in 2 cases, and at both the chest and the back of the ear in 1 case. All the wounds were repaired by pedicled omental flap transplantation. The wound area after debridement was 2-15 cm ². After operation, the wound healing and related complications (pain, infection, incisional hernia, omental flap necrosis, etc.) were observed. During follow-up, the recurrence of the wound was observed. Results The wounds of all 5 patients healed within 2 weeks after operation, without related complications. During follow up of 12-18 months, 1 patient got a recurrence of rejection wound behind the left ear 4 months after surgery and eventually had the brain pacemaker removed; the other 4 patients had no recurrence of wounds. Conclusions Pedicled omental flap transplantation can repair the secondary rejection wounds after brain pacemaker implantation safely and effectively, with few postoperative complications.
- Parkinson disease /
- Inflammation /
- Brain pacemaker /
- Rejection wound /
- Wound repair /
- Subcutaneous pocket /
- Omentum
所有作者均声明不存在利益冲突

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参考文献(18)

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1 带蒂大网膜瓣移植修复脑起搏器置入后继发排异创面的手术过程。1A.沿横结肠上缘游离大网膜；1B.将大网膜以一侧胃网膜动脉为蒂完全游离；1C.将游离的带蒂大网膜瓣拉出腹腔，沿腹部无张力拉伸经胸部至头颈部，评估大网膜瓣长度是否足够到达胸前及耳后创面；1D.将带蒂大网膜瓣经皮下隧道无张力拉至胸前囊袋；1E.在胸前囊袋处用大网膜瓣完全包裹脉冲发生器；1F.在耳后区域用大网膜瓣完全覆盖该处暴露的延长导线

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2 带蒂大网膜瓣移植修复患者脑起搏器置入后继发排异创面手术前后的对比情况。2A、2B.分别为术前患者右侧耳后创面、左侧胸前创面情况，2处创面均出现排异反应；2C、2D.分别为大网膜瓣移植术（同时进行了脑起搏器置换术）后12个月随访时，患者右侧耳后创面、右侧胸前创面情况，2处创面均愈合良好

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