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Techniques chirurgicales - Chirurgie plastique reconstructrice et esthétique

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Reconstruction pelvipérinéale - 01/01/06

[45-685] - Doi : 10.1016/S1286-9325(06)40161-8

D. Gangloff ^a,^b,^⁎ , G.-E. Ferron ^b, I. Garrido ^b, G. Fabre ^a, P. Martel ^b, D. Querleu ^b, J.-P. Chavoin ^a, J.-L. Grolleau-Raoux ^a
^a Service de chirurgie plastique et des brûlés, centre hospitalier universitaire Rangueil, Toulouse, France
^b Service de chirurgie, Centre de lutte contre le cancer, Institut Claudius Régaud, Toulouse, France

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Artículo archivado , publicado en el tratado Techniques chirurgicales - Chirurgie plastique reconstructrice et esthétique y reemplazado por un artículo más reciente: clic aquí para acceder

Résumé

La reconstruction pelvipérinéale recouvre un nombre important de situations cliniques et sollicite un large panel d'options techniques. Le chirurgien plasticien en tant qu'expert de la restauration cutanée est partie prenante dans le cadre d'une prise en charge multidisciplinaire impliquant aussi chirurgiens gynécologues, urologues ou digestifs. Nous faisons le point sur les multiples options de reconstruction exploitables dans cette région en organisant l'exposé en deux grands chapitres : les techniques de resurfaçage pelvipérinéales, faisant suite à une exérèse superficielle où seul l'apport de peau est impératif ; les techniques de comblement, le plus souvent faisant suite à une exentération pelvienne qui rend nécessaire l'apport d'un tissu bien vascularisé dans une cavité généralement irradiée.

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Mots clés : Reconstruction périnéale, Reconstruction pelvis, Chirurgie plastique, Chirurgie des lambeaux

Esquema

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, ]

Resurfaçage pelvipérinéal

Greffes de peau^{[Friedman J., Dinh T., Potochny J. Reconstruction of the perineum Semin. Surg. Oncol. 2000 ; 19 : 282-293 3.0.CO;2-B">[cross-ref]}

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Lambeaux cutanés et fasciocutanés locorégionaux

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]}

Techniques de comblement

Lambeau de muscle grand droit de l'abdomen

Lambeau de muscle droit interne de cuisse (gracilis)

Lambeau glutéal inférieur (« gluteal thigh flap »)

Autres lambeaux musculocutanés

Lambeau d'épiploon^{[Kusiak J.F., Rosenblum N.G. Neovaginal reconstruction after exenteration using an omental flap and split-thickness skin graft Plast. Reconstr. Surg. 1996 ; 97 : 775-783

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, Micheau P. The greater omentum. Its role in reconstructive plastic surgery Ann. Chir. Plast. Esthet. 1995 ; 40 : 192-207

]}

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Principes de la chirurgie plastique
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