Perforator-sparing abdominoplasty technique in the presence of bilateral subcostal scars after gastric bypass.

Détails

ID Serval
serval:BIB_9BB273C1C233
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Perforator-sparing abdominoplasty technique in the presence of bilateral subcostal scars after gastric bypass.
Périodique
Obesity Surgery
Auteur(s)
Rieger U.M., Aschwanden M., Schmid D., Kalbermatten D.F., Pierer G., Haug M.
ISSN
0960-8923
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
17
Numéro
1
Pages
63-67
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article - Publication Status: ppublish
Résumé
BACKGROUND: The number of patients after gastric bypass being referred to plastic surgery units for secondary plastic surgery procedures is increasing. The characteristic abdominal deformity includes a draping apron of panniculus, occasionally associated with previous transverse surgical scars in the upper abdomen. Often a limited abdominoplasty of the low transverse type with limited undermining only up to the level of the umbilicus is performed in order not to compromise blood supply in the zone between the old transverse and the new transverse scar. METHOD: We propose a new, modified and safe surgical technique to perform a complete abdominoplasty with wide undermining up to the xiphoid process in patients with preexisting transverse subcostal scars after gastric bypass surgery, by selectively dissecting and preserving one to three periumbilical abdominal wall perforator vessels to secure flap blood supply. Vessel tunnelling through the rectus sheath and muscle and ligation of the cephalad branch of the perforator provide sufficient flap mobility without perforator tension or traction. Flap undermining is performed around these perforator vessels. To match dissected flap perforators with blood-flow, we performed post-operative color-flow duplex scanning. RESULTS: We treated two patients according to this new technique. In both cases the postoperative course was uneventful and a good aesthetic result was achieved. CONCLUSION: We conclude from our experience that with this perforator-sparing abdominoplasty technique, safe and complete abdominoplasty can be performed with no additional risk of complications and that a good cosmetic result can be achieved in patients after open gastric bypass surgery.
Mots-clé
Abdomen/surgery, Adult, Cicatrix/etiology, Cicatrix/surgery, Female, Gastric Bypass/adverse effects, Humans, Obesity, Morbid/surgery, Reconstructive Surgical Procedures/methods, Skin/surgery, Subcutaneous Tissue/surgery, Surgical Flaps, Treatment Outcome
Pubmed
Web of science
Création de la notice
18/02/2008 9:27
Dernière modification de la notice
20/08/2019 15:02
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