PDF(Pubmed)
Abstract：
Ventral abdominal hernias are a common abdominal wall defect in the United States. We present a 50-year-old Caucasian male with a large (>18 cm) abdominal wall defect. An extensive complex abdominal wall reconstruction with advanced bilateral fascial flaps/component separation and repair of the abdominal wall defect was planned to restore the appropriate abdominal wall anatomic contour. The use of double mesh in large abdominal wall defects is still a relatively new documented technique. Only two case series detail the same technique used on this patient, with no articles on using a hybrid mesh with a synthetic absorbable mesh. This case uses an underlay and onlay mesh technique, with a hybrid mesh, Tela Biologics (Malvern, PA, USA), under the muscle, in this case, intraperitoneal bridging the gap. The anterior rectus sheath was reinforced with intercepted 0-Ethibond sutures (Ethicon/J&J, Bridgewater, NJ, USA) and then reinforced with a synthetic absorbable mesh (PhasixTM, Becton Dickinson, Franklin Lakes, NJ). The outcome with this patient shows more research should be conducted on considering long-term results with the types of mesh and the question of whether there are additional benefits when using two different types of mesh and their placement in the sandwich technique.
摘要：
腹侧疝是美国常见的腹壁缺损。我们介绍了一名50岁的白人男性，其腹壁缺损较大（>18cm）。计划进行广泛的复杂腹壁重建，并进行先进的双侧筋膜瓣/组件分离和腹壁缺损修复，以恢复适当的腹壁解剖轮廓。在大腹壁缺损中使用双网仍然是一种相对较新的文献技术。只有两个病例系列详述了对该患者使用的相同技术，没有使用混合网状物与合成可吸收网状物的文章。这种情况下使用了底图和onlay网格技术，使用混合网格，泰拉生物制品（马尔文，PA,美国),肌肉下面，在这种情况下,腹膜内桥接间隙。前直肌鞘用截获的0-Ethibond缝线加固(Ethicon/J&J，布里奇沃特,NJ,美国)，然后用合成可吸收网状物(PhahsixTM，BectonDickinson,富兰克林湖,NJ).该患者的结果表明，应该进行更多的研究，以考虑网状物类型的长期结果，以及使用两种不同类型的网状物及其在三明治技术中的放置是否有额外的益处的问题。
