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Dissertation zugänglich unter
URN: urn:nbn:de:gbv:18-38266
URL: http://ediss.sub.uni-hamburg.de/volltexte/2008/3826/


Anwendungsmöglichkeiten des Musculus latissimus dorsi

Versatile Use Of The Latissimus Dorsi - Flap

Pätsch, Helene Sophie

pdf-Format:
 Dokument 1.pdf (3.295 KB) 


SWD-Schlagwörter: Transplantation
Freie Schlagwörter (Deutsch): M. latissimus dorsi , Transplantation
Freie Schlagwörter (Englisch): M. latissimus dorsi , Transplantation
Basisklassifikation: 44.65
Institut: Medizin
DDC-Sachgruppe: Medizin, Gesundheit
Dokumentart: Dissertation
Hauptberichter: Schmelzle, Rainer (Prof. Dr. Dr.)
Sprache: Deutsch
Tag der mündlichen Prüfung: 04.07.2008
Erstellungsjahr: 2008
Publikationsdatum: 04.09.2008
Kurzfassung auf Deutsch: Anwendungsmöglichkeiten des M. latissimus dorsi bei der Defektdeckung und Rekonstruktion. Auswertung und Beurteilung der Transplantationen in der Nordwestdeutschen Keiferklinik des Universitätsklinikums Hamburg - Eppendorf.
Kurzfassung auf Englisch: Versatile Use Of The Latissimus Dorsi – Flap

Introduction:
Since 1906 the latissimus dorsi – flap has been used in plastic and reconstructive surgery. Tumor extirpation, injury and infection for instance, can result in large defects requiring coverage of allograft – constructs and vital neurovascular strucktures. Due to its reliability, durability and good cosmetic results this flap is still a popular choice for reconstructive matters.

Abstract/ Study:
Over a period of eight years 86 latissimus dorsi – flaps have been performed by one surgent at the Universitätsklinikum Hamburg – Eppendorf.
This retrospective study evaluates the results of 83 patients who have undergone a latissimus dorsi – flap reconstruction between 1998 and 2006.
(The evaluation included reliability , apply, versatility, complications, surgical improvements and the flap surviving – rate of the latissimus dorsi – flap).

There were used 12 pedicled flaps and 74 free flaps. Three of the 83 patients required two flaps. Considering only the free flap there were five patients who required a combined flap. The average of the age was 53,5 years. Tumor extirpation (PEC 50,6%)was the most often reason for defect coverage by flap reconstruction.

Results:
Two patients experienced a flap loss (due to arterial insuffizienz and torsion of a vessel). One patient developed a partial flap necrosis which could be prevented by a surgical revision. 20,5% of the patients developed local recurrences.
There was an improvement of up to three hours surgical time. (Free flap: 6h 40min. to 3h 40min.) 75% of the flap - reconstruction were undertaken in the area of face and scalf. It could be achieved a flap surviving rate of 97,6%. A revision of flap reconstruction improved from 100% to hardly 0%.

Conclusion:
In our study, the latissimus dorsi – flap was an excellent choice for the reconstructions of complex defects within the area of face and heat.

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