■安全带综合症(SBS)是一种罕见的疾病,被描述为由于胸部受伤,腹部,在交通事故的背景下骨盆受压。这些损伤可以从轻微的皮肤擦伤到内脏器官和脊髓受累的大损伤。外伤性腹壁疝(TAWH)是可能相关的损伤之一。
方法:一名21岁男性严重受伤,由于SBS导致所有腹壁肌肉组织完全横切,伴有内脏损伤。急诊手术包括肠和乙状结肠切除术,随着静脉修复。经过长时间的恢复,计划进行腹壁重建的第二阶段手术.康复治疗涉及肉毒杆菌毒素和气腹,利用CT扫描和三维重建的手术计划。第二阶段手术包括腹横肌释放和双网放置。
■处理多发伤患者的外伤性腹壁疝需要紧急手术治疗,虽然重建手术时机至关重要,病人的准备是必不可少的。手术计划,包括3D重建,提高准确性,和安全,根据解剖学特征选择修复技术。鉴于我们患者的运动背景和术前血管CT检查结果,选择无瓣重建手术以减轻血管风险.
结论:创伤性腹壁损伤的治疗方法应针对每位患者进行个体化治疗。重点是首先解决重要的伤害,并在随后的阶段考虑腹壁重建手术。在涉及严重腹壁缺损的情况下,利用CT扫描和3D重建可以成为术前计划的宝贵工具。
UNASSIGNED: Seat belt syndrome (SBS) is a rare condition described as injuries sustained due to thoracic, abdominal, and pelvic compression in the context of traffic accidents. These injuries can range from minor skin abrasions to large lesions of internal organs and spinal cord involvement. Traumatic abdominal wall hernias (TAWH) are one of the injuries that can be associated.
METHODS: A 21-year-old male suffered a severe injury, resulting in complete transection of all abdominal wall musculature due to SBS, with associated visceral injury. Emergency surgery included intestinal and sigmoid colon resection, along with cava vein repair. After a prolonged recovery, a second-stage surgery for abdominal wall reconstruction was planned. Prehabilitation involved botulinum toxin and pneumoperitoneum, with surgical planning utilizing CT scan and 3D reconstruction. The second-stage surgery included transversus abdominis release and placement of double mesh.
UNASSIGNED: Managing traumatic abdominal wall hernias in polytrauma patients necessitates emergent surgery for vital injuries, while reconstructive surgery timing is crucial, with patient preparation being essential. Surgical planning, including 3D reconstructions, enhances accuracy, and safety, with repair technique selection depending on anatomical features. Given our patient\'s athletic background and preoperative vascular CT findings, flapless reconstructive surgery was chosen to mitigate vascular risks.
CONCLUSIONS: The therapeutic approach to traumatic abdominal wall injuries should be individualized to each patient, with a focus on addressing vital injuries first and considering abdominal wall reconstruction surgery at a subsequent stage. Utilizing CT scan with 3D reconstruction can be a valuable tool for preoperative planning in cases involving significant abdominal wall defects.