Abstract
A combined technique of patchplasty with expanded polytetrafluoroethylene (PTFE) and a special skinplasty is described for congenital abdominal wall defects where the abdominal cavity needs enlargement but skin closure is primarily possible. The patchplasty consists of suturing two half-moon-shaped, expanded PTFE leaves to the sides of the muscular abdominal wall, then approximating them under observation of intra-abdominal pressure by monitoring five parameters (urinary bladder pressure, central venous pressure, transcutaneous oxygen saturation, ventilation pressure, and mean arterial pressure). The skin is incised in a horizontal manner according to the tension lines. However, after closure, regional necrosis of the skin in the mid-portion above the incision is often observed due to lack of sufficient subcutaneous tissue at this site. Therefore, a skinplasty is done as a preventive measure, resecting this potential site of necrosis. The final appearance of the skin is an inverted T-shape. The surgical and monitoring techniques are described and illustrated.
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Correspondence to: A. Rokitansky
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Rokitansky, A.M., Kolankaya, A. & Semsroth, M. Patchplasty with expanded polytetrafluoroethylene and skinplasty for the closure of large congenital abdominal wall defects. Pediatr Surg Int 9, 227–230 (1994). https://doi.org/10.1007/BF00179623
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DOI: https://doi.org/10.1007/BF00179623