Laparoscopic harvest and free transplantation of great omentum flap for extensive tissue defects in complex wounds
Jiaqi Liu,
Juntao Han,
Gang Ji,
Ting Zhang,
Songtao Xie,
Yang Liu,
Yuehua Li,
Chi Ma,
Zhao Zheng,
Dahai Hu
Affiliations
Jiaqi Liu
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
Juntao Han
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
Gang Ji
Department of Gastroenterology, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
Ting Zhang
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
Songtao Xie
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
Yang Liu
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
Yuehua Li
Department of Digestive Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 3 Shang Qin Road, Xi'an, Shaanxi, 710004, China
Chi Ma
Department of Burns and Plastic Surgery, the Fifth People's Hospital of Datong, 615 Wenxing Road, Datong, Shanxi, 037006, China
Zhao Zheng
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China; Corresponding authors at: Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi 710032, China.
Dahai Hu
Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China; Corresponding authors at: Xijing Hospital, The Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi 710032, China.
Introduction: The repair of extensive tissue defects remains a challenge, although great progress has been made in reconstructive surgery. The transplantation of a single huge flap or several flaps in combination will inevitably result in donor-site morbidity. Here we report our experience in the repair of these wounds with laparoscopically harvested great omentum flaps. Methods: Twelve patients with extensive tissue defects caused by deep burn injury, avulsion injury, and open fracture underwent free omental flap transplantation and split-thickness skin grafting. The patient demographics, wound characteristics, and complications postsurgical operation were recorded. Prior to omentum flap transplantation, these patients underwent debridement, vacuum sealing drainage treatment, and/or fixation of fractures. All omentum flaps harvested using laparoscopic technique were anastomosed to recipient vessels, and split-thickness skin grafting was performed 14 days after omental flap transplantation. Results: The mean defect size was 471 cm2 and the mean omental flap size was 751.1 cm2. Among all 12 cases, the omental flaps survived well except for distal partial necrosis in one case. Skin grafting was also achieved in all cases, and all patients achieved complete wound coverage. All donor sites achieved primary healing without major complications. The mean follow-up time was 30 months with satisfactory appearance and functional outcome. Conclusion: For the reconstruction of extensive tissue defects in complex wounds, the free transfer of an omental flap may be an ideal option because of its well-vascularized and pliable tissue with reliable vascular anatomy, as well as minimized donor-site morbidity.
