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Composite- und Chimärenlappen in der Traumaversorgung

Composite and chimeric flaps in trauma management

Trauma und Berufskrankheit

Zusammenfassung

Die verschiedenen plastisch-chirurgischen Deckungsverfahren innerhalb der rekonstruktiven Strategien erfuhren in den letzten Jahren durch die Möglichkeit des simultanen Mehrgewebetransfers eine entscheidende Erweiterung. Dabei können sowohl durch freie mikrovaskuläre als auch gestielte Lappenplastiken in einem Eingriff mehrere Arten von Geweben zur optimierten funktionellen und ästhetischen Defektrekonstruktion verwendet werden. Je nach vaskulärer Verbindung und räumlicher Zusammensetzung der unterschiedlichen Gewebearten (Haut, Fett, Knochen, Muskel, Nerv, Faszie, Gefäße usw.) lassen sich dabei unterschiedliche Konstrukte heben, welche gestielte axiale Lappen bis hin zu mikrochirurgischen zusammengesetzten sequenziellen Chimärenlappen umfassen. Ziel dabei ist es, dem Patienten die optimale und insgesamt zeitsparende Versorgung im Rahmen des rekonstruktiven Ersteingriffs zu ermöglichen. Die hierbei initial etwas längeren Operationszeiten werden oft durch die Reduktion der Anzahl und Komplexität von Folgeeingriffen aufgewogen.

Abstract

In the recent years, the variety of plastic surgical methods for defect closure among the different reconstructive strategies has been expanded by simultaneous multi-tissue transfer options. Both free microvascular and pedicled flaps may be used for optimized functional and aesthetic defect closure by simultaneous tissue transfer in a single operation. According to their vascular connection and spatial relationship of the different tissue types (skin, fat, bone, muscle, nerve, fascia, vessels etc.) there are various different tissue transplants ranging from simple axial pattern flap to microsurgically constructed sequential chimeric free flaps. The goal with these flaps is to achieve an optimal and overall time-saving treatment with the first reconstructive procedure. Though the initial operative time might be slightly longer, the number and complexity of subsequent procedures are reduced.

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Correspondence to G.A. Giessler.

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Giessler, G., Schmidt, A. Composite- und Chimärenlappen in der Traumaversorgung. Trauma Berufskrankh 13, 104–108 (2011). https://doi.org/10.1007/s10039-011-1723-2

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  • DOI: https://doi.org/10.1007/s10039-011-1723-2

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