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| PRIMENA PEKTORALIS MAJOR REŽNJA U KLINIČKOJ PRAKSI [ APPLICATION OF THE PECTORALIS MAJOR LOBE IN THE CLINIC PRACTICE ] Milan VIŠNJIĆ, Predrag KOVAČEVIĆ AMM 2000; 39(3):15-28 ICID: 897384 |
| Article type: Original article |
| IC™ Value: 3.00 |
| U periodu od 1985 do 1998 godine u Hirurškoj klinici u Nišu pektoralis major režanj primenjen je kod 40 bolesnika sa velikim defektom kože koji se klasičnim metodama teško mogao rekonstruisati. Miokutani režanj je korišcen kod 38 bolesnika (95%), ostemiokutani režanj kod jednog bolesnika (2,5) i mišićni pektoralis major režanj kod jednog bolesnika (2,5%). Kod svih bolesnika defekt je bio posledica operativnog lečenja tumora kože i potkožnog tkiva i to: u predelu orbite - 2 bolesnika, lica - 14 bolesnika (kod jednog bolesnika je primenjen ostemiokutani režanj), vrata- 11 bolesnika, grudnog koša 8 bolesnika (kod jednog bolesnika je primenjen mišicni režanj sa trans- plantatom kože), i ramena kod 5 bolesnika. Sekundarni defekt je kod svih direktno suturiran. Kod jednog bolesnika registrovana je nekroza celog režnja zbog hematoma, a kod 3 bolesnika parcijalna nekroza režnja (zbog infekcije) koja je zbrinuta nekrektomijom i sekundarnim šavom. Jedan bolesnik je u postoperativnom toku egzitirao. Kod ostalih bolesnika režanj je u potpunosti prihvaćen. Ostrvasti pektoralis major mišićno kožni režanj se sa uspehom može koristiti za rekonstrukciju velikih defekata kože u predelu lica vrata, grudnog koša i ramena. Tehnika podizanja ovog režnja je relativno jednostavna, a komplikacije retke. |
English: In the period from 1985 to 1998 at the Surgery Clinic, Nis, the pectoralis major lobe was applied to 40 patients with a large skin defect that could hardly be reconstructed by the traditional methods. The myocutaneous lobe was used with 38 patients (95%), the osteomyocutaneous lobe in one patient (2,5%) and the muscular pectoralis major lobe in one patient (2,5%). In all the patients, the defect was a consenquence of the operative treatment of the skin or the subcutaneous tissue tumor, namely, in the orbit area (2 patients), in the face (14 patients - one patient had an osteomyocutaneous lobe applied), in the neck (11 patients), in the thoracic cavity (8 patients - one patient had a muscular lobe with the skin transplant applied) and in the shoulders (5 patients). The secondary defect is directly sutured in all of them. In one patient the necrosis of the whole lobe due to a hematoma is registered, while in 3 patients a partial lobe necrosis (due to infection) has been taken care of by necrectomy and a secondary suture. In all the other patients the lobe has been comletely accepted. The island-like pectoralis major muscular-cutaneous lobe can be successfully used for reconstructing great skin defect in the area of the face, neck, thoracic cavity and shoulders. The technique of lifting the lobe is relatively simple while the complications are rare. |
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ICID 897384 |
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