Pedicled Greater Omentum Transferred to the Spine in a Case of Postoperative Infection

Giordano, P.; Griffet, J.; Argenson, C

doi:10.1097/00006534-199406000-00030

Cited by 27 publications

(13 citation statements)

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“…For lumbosacral or sacral defects the gluteus maximus muscle or musculocutaneous flap is generally recommended, with several modifications [15,25,26,30]. The greater omental flap has also been advocated for coverage of such defects [12,18]. In our series the lumbosacral defects in patients 3 and 5 were successfully reconstructed using the superior gluteus maximus muscle flap to obliterate the dead space and local flaps for skin cover.…”

Section: Discussionmentioning

confidence: 91%

Immediate debridement and coverage of exposed spinal hardware with muscle flaps

Akyürek

Şafak

Alanay

et al. 2002

European Journal of Plastic Surgery

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We report the outcome of immediate débride-ment and soft tissue cover of spinal wounds secondary to exposure of orthopedic hardware, using local muscle or musculocutaneous flaps. Five patients were treated (mean age 18 years). Radical débridement was performed prior to flap closure. Depending on the location of the defect, a pedicled muscle or myocutaneous flap was selected, alone or in combination with latissimus dorsi, trapezius, gluteus maximus, or paraspinous muscles. The implants were successfully covered. The hardware was maintained until solid spinal fusion was achieved. We recommend early and definitive cover of exposed spinal fusion devices using local muscle or musculocutaneous flaps; the choice depends on the location of the defect. By this approach the wound can be effectively repaired with a well-vascularized muscle flap covering the hardware, thus obviating the need for its removal and thus ensuring spinal stability.

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Section: Discussionmentioning

confidence: 91%

Immediate debridement and coverage of exposed spinal hardware with muscle flaps

Akyürek

Şafak

Alanay

et al. 2002

European Journal of Plastic Surgery

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“…23 Omentum has been infrequently used here as elsewhere in the posterior trunk, and almost always as a last resort. 6,24 Lumbar As defined by Geddes et al, 1 the lumbar region extends caudally from below the costal margin of the upper back to the posterior superior iliac spines and along the iliac crests (Fig. 1).…”

Section: Midthoracicmentioning

confidence: 96%

Reconstruction of Posterior Trunk Defects

Hallock

2011

Seminars in Plastic Surgery

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The posterior trunk roughly encompasses the upper back from the shoulders to the lumbar area above the iliac crests. Long-term outcomes in the treatment of defects of the spine and bony thorax have been proved superior if flaps were used. Many local muscle and fasciocutaneous flaps are available alternatives. A guideline, patterned according to arbitrary anatomic territories of the back, is suggested as a starting point for the selection of appropriate primary and secondary flap options. Depending on flap availability, the latissimus dorsi and trapezius muscles are the workhorse flaps for the upper back, whereas perforator flaps have become a useful alternative for the lumbar region in lieu of free flaps.

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“…The main disadvantage of the omental flap is the need for a combined anterior and posterior approach which increases morbidity and creates problems in positioning. [74][75][76] Potential complications secondary to the laparotomy include possible obstruction of the small bowel, hernia of the ventral wall and fluid-electrolyte disturbances. These problems have limited the use of omental flaps in the cover of complex spinal wounds.…”

Section: Anatomical Approach To Flap Availabilitymentioning

confidence: 99%