Interdisciplinary aspects of abdominal and plastic surgery - what does the (abdominal) surgeon need to know?
Abstract
[INTRODUCTION] The aim was to reflect the established interdisciplinary aspects of general/abdominal and plastic surgery by means of a narrative review. Methods: (i) With specific references out of the medical literature and (ii) own clinical and perioperative as well as operating technical and tactical management experiences obtained in surgical daily practice, we present a choice of options for interdisciplinary cooperation that could be food of thought for other surgeons.
[CONTENT] - Decubital ulcers require pressure relieve, debridement and plastic surgery coverage, e.g., by a rotation flap plasty, V-Y flap or "tensor-fascia-lata" (TFL) flap depending on localization (sacral/gluteal defects, ischiadic tuber). - Coverage of soft tissue defects, e.g., after lymph node dissection, tumor lesions or disturbance of wound healing can be managed with fasciocutaneous or muscle flaps. - Bariatric surgery: Surgical interventions such as butt lift, tummy tuck should be explained and demonstrated in advance and performed commonly after reduction of the body weight. - Abdominoperineal rectum extirpation (APE): Holm's procedure with greater circumferential extent of resection at the mesorectum and the insertion site of the levator muscle at the anal sphicter muscle resulting in a substantial defect is covered by myocutaneous flap plasty. - Hernia surgery: Complicated/recurrent hernias or abdominal wall defect can be covered by flap plasty to achieve functional reconstruction, e.g., using innervated muscle. Thus, abdominal wall can respond better onto changes of pressure and tension. - Necrotising fasciitis: Even in case of suspicious fasciitis, an immediate radical debridement must be performed, followed by intensive care with calculated antibiotic treatment; after appropriate stabilization tissue defects can be covered by mesh graft of flap plasty. - Soft tissue tumor lesions cannot be resected with primary closure to achieve appropriate as intended R0 resection status by means of local radical resection all the time - plastic surgery expertise has to be included into interdisciplinary tumor concepts. - Liposuction/-filling: Liposuction can be used with aesthetic intention after bariatric surgery or for lipedema. Lipofilling is possible for reconstruction and for aesthetic purpose. - Reconstruction of lymphatic vessels: Lymphedema after tumor operations interrupting or blocking lymphatic drainage can be treated with microsurgical reconstructions (such as lympho-venous anastomoses, lympho-lymphatic anastomoses or free microvascular lymph node transfer). - Microsurgery: It is substantial part of modern reconstructive plastic surgery, i.e., surgery of peripheral nerves belongs to this field. For visceral surgery, it can become important for reconstruction of the recurrent laryngeal nerve. - Sternum osteomyelitis: Radical debridement (eventually, complete sternal resection) with conditioning of the wound by vacuum-assisted closure followed by plastic surgery coverage can prevent chronification, threatening mediastinitis, persisting infectious risk, long-term suffering or limited quality of life.
[SUMMARY] The presented selection of single topics can only be an excerpt of all the options for surgical cooperation in daily clinical and surgical practice.
[OUTLOOK] An interdisciplinary approach of abdominal and plastic surgery is characterized by a highly developed cooperation in common surgical interventions including various techniques and tactics highlighting the specifics of the two fields.
[CONTENT] - Decubital ulcers require pressure relieve, debridement and plastic surgery coverage, e.g., by a rotation flap plasty, V-Y flap or "tensor-fascia-lata" (TFL) flap depending on localization (sacral/gluteal defects, ischiadic tuber). - Coverage of soft tissue defects, e.g., after lymph node dissection, tumor lesions or disturbance of wound healing can be managed with fasciocutaneous or muscle flaps. - Bariatric surgery: Surgical interventions such as butt lift, tummy tuck should be explained and demonstrated in advance and performed commonly after reduction of the body weight. - Abdominoperineal rectum extirpation (APE): Holm's procedure with greater circumferential extent of resection at the mesorectum and the insertion site of the levator muscle at the anal sphicter muscle resulting in a substantial defect is covered by myocutaneous flap plasty. - Hernia surgery: Complicated/recurrent hernias or abdominal wall defect can be covered by flap plasty to achieve functional reconstruction, e.g., using innervated muscle. Thus, abdominal wall can respond better onto changes of pressure and tension. - Necrotising fasciitis: Even in case of suspicious fasciitis, an immediate radical debridement must be performed, followed by intensive care with calculated antibiotic treatment; after appropriate stabilization tissue defects can be covered by mesh graft of flap plasty. - Soft tissue tumor lesions cannot be resected with primary closure to achieve appropriate as intended R0 resection status by means of local radical resection all the time - plastic surgery expertise has to be included into interdisciplinary tumor concepts. - Liposuction/-filling: Liposuction can be used with aesthetic intention after bariatric surgery or for lipedema. Lipofilling is possible for reconstruction and for aesthetic purpose. - Reconstruction of lymphatic vessels: Lymphedema after tumor operations interrupting or blocking lymphatic drainage can be treated with microsurgical reconstructions (such as lympho-venous anastomoses, lympho-lymphatic anastomoses or free microvascular lymph node transfer). - Microsurgery: It is substantial part of modern reconstructive plastic surgery, i.e., surgery of peripheral nerves belongs to this field. For visceral surgery, it can become important for reconstruction of the recurrent laryngeal nerve. - Sternum osteomyelitis: Radical debridement (eventually, complete sternal resection) with conditioning of the wound by vacuum-assisted closure followed by plastic surgery coverage can prevent chronification, threatening mediastinitis, persisting infectious risk, long-term suffering or limited quality of life.
[SUMMARY] The presented selection of single topics can only be an excerpt of all the options for surgical cooperation in daily clinical and surgical practice.
[OUTLOOK] An interdisciplinary approach of abdominal and plastic surgery is characterized by a highly developed cooperation in common surgical interventions including various techniques and tactics highlighting the specifics of the two fields.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | flap
|
피판재건술 | dict | 6 | |
| 시술 | liposuction
|
지방흡입 | dict | 2 | |
| 시술 | tummy tuck
|
복부성형술 | dict | 1 | |
| 시술 | microvascular
|
미세수술 | dict | 1 | |
| 시술 | microsurgery
|
미세수술 | dict | 1 | |
| 해부 | TFL
→ tensor-fascia-lata"
|
scispacy | 1 | ||
| 해부 | soft tissue
|
scispacy | 1 | ||
| 해부 | body
|
scispacy | 1 | ||
| 해부 | circumferential
|
scispacy | 1 | ||
| 해부 | muscle
|
scispacy | 1 | ||
| 해부 | tissue
|
scispacy | 1 | ||
| 해부 | graft
|
scispacy | 1 | ||
| 해부 | visceral
|
scispacy | 1 | ||
| 해부 | levator muscle
|
상안검거근 | dict | 1 | |
| 합병증 | abdominal
→ abdominal and plastic surgery - what does the
|
scispacy | 1 | ||
| 합병증 | V-Y flap
|
scispacy | 1 | ||
| 합병증 | wound
|
scispacy | 1 | ||
| 합병증 | muscle flaps
|
scispacy | 1 | ||
| 합병증 | anal sphicter
|
scispacy | 1 | ||
| 합병증 | myocutaneous flap
|
scispacy | 1 | ||
| 합병증 | abdominal wall
|
scispacy | 1 | ||
| 합병증 | flap plasty
|
scispacy | 1 | ||
| 합병증 | lipedema
|
scispacy | 1 | ||
| 합병증 | lympho-venous anastomoses
|
scispacy | 1 | ||
| 합병증 | sternal
|
scispacy | 1 | ||
| 약물 | [INTRODUCTION] The
|
scispacy | 1 | ||
| 질환 | ulcers
|
C0041582
Ulcer
|
scispacy | 1 | |
| 질환 | tumor
|
C0027651
Neoplasms
|
scispacy | 1 | |
| 질환 | APE
|
C0032636
Pongidae
|
scispacy | 1 | |
| 질환 | hernias
|
C0019270
Hernia
|
scispacy | 1 | |
| 질환 | fasciitis
|
C0015645
Fasciitis
|
scispacy | 1 | |
| 질환 | lipedema
|
C0398370
Lipedema
|
scispacy | 1 | |
| 질환 | Lymphedema
|
C0024236
Lymphedema
|
scispacy | 1 | |
| 질환 | Sternum osteomyelitis
|
C0749007
Sternal osteomyelitis
|
scispacy | 1 | |
| 질환 | mediastinitis
|
C0025064
Mediastinitis
|
scispacy | 1 | |
| 질환 | ischiadic tuber
|
scispacy | 1 | ||
| 질환 | tumor lesions
|
scispacy | 1 | ||
| 질환 | mesorectum
|
scispacy | 1 | ||
| 질환 | Soft tissue tumor lesions
|
scispacy | 1 | ||
| 기타 | lymph node
|
scispacy | 1 | ||
| 기타 | rectum
|
scispacy | 1 | ||
| 기타 | lymphatic vessels
|
scispacy | 1 | ||
| 기타 | lymphatic
|
scispacy | 1 | ||
| 기타 | lympho-lymphatic anastomoses
|
scispacy | 1 | ||
| 기타 | microvascular lymph node
|
scispacy | 1 | ||
| 기타 | peripheral nerves
|
scispacy | 1 | ||
| 기타 | laryngeal nerve
|
scispacy | 1 |
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