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Zentralbl Chir 2006; 131: 141-145
DOI: 10.1055/s-2006-921507
Originalarbeit

© Georg Thieme Verlag Stuttgart · New York

Rekonstruktion von tumorbedingten Defekten in der Kopf-Hals-Chirurgie mit individualisierten dreidimensionalen Lappen unter Anwendung der Vakuumtherapie

Reconstruction of Tumor Induced Defects in Head and Neck Surgery with Individualized Prefabricated Threedimensional Flaps with the Use of Continuous Vacuum TherapyJ. Schipper1 , M. Leffler2 , W. Maier1 , J. Kopp2 , A. D. Bach2 , R. E. Horch2
  • 1Universitäts-HNO-Klinik Freiburg
  • 2Universitätsklinikum Erlangen, Abteilung für Plastische Chirurgie und Handchirurgie
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Publication History

Publication Date:
30 March 2006 (online)

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Zusammenfassung

Trotz der Weiterentwicklungen funktionserhaltender multimodaler Tumorkonzepte in der onkologischen Kopf-Hals-Chirurgie stellen große und funktionelle Defekte nach radikaler Tumorresektion noch immer eine Herausforderung für den Chirurgen dar. Individuell präfabrizierte freie Lappenplastiken können mit der computer-kontrollierten kontinuierlichen Vakuumtherapie gezielt hergestellt werden, um die jeweiligen funktionellen Defekte zu ersetzen. Dieses beschleunigt die Präfabrikation dreidimensionaler Lappenplastiken und erhöht die Sicherheit des Verfahrens. Veränderungen der genuinen Struktur solcher Lappen werden durch die Implantation von auto- oder heterologen Transplantaten, alleine oder in Kombination mit alloplastischen Materialien als Stützelemente erzielt. Die Anwendung der Vakuumtherapie hilft dabei, den Prozess der Präfabrikation durch die Induktion der Angiogenese zu beschleunigen. Neben der kontinuierlichen Sekretableitung und Verhinderung der sekundären Kompression durch Gewebeschichten durch Hämatome oder Serome wird die Modellierung des dreidimensionalen Konstruktes unterstützt. Diese Arbeit beschreibt die Technik der Vakuumtherapie zur Präfabrikation dreidimensionaler gestielter oder freier Lappenplastiken zur Rekonstruktion von Tumordefekten nach onkologischen Resektionen im Kopf-Hals-Bereich.

Abstract

Despite recent developments in oncologic head and neck surgery extensive tissue and functional defects following radical tumor resections remains a surgical challenge. Individually prefabricated free flaps to meet the needs of the functional defect can be generated with the help of continuous computer-assisted vacuum therapy. This accelerates the prefabrication of three-dimensional composite flaps and enhances therapeutic safety. Changes of the geniuine structure of such flaps are induced by implantation of autologous or heterologous transplants alone or in combination with alloplastic materials as a supportive element. Application of vacuum therapy is useful to accelerate the process of prefabrication by the induction of angiogenesis. Besides this the continuous removal of wound exudate, possible seroma or haematoma and secondary compression of the different tissue layers improve the modelling of the three-dimensional construct. This article describes the technique of vacuum therapy for the prefabrication of three-dimensional pedicled or free flaps for reconstruction of defects after tumor resection in the head and neck area.

Schlüsselwörter

Lappenpräfabrikation - Tumordefektrekosntruktion - Vakuumtherapie - Gesicht-Hals-Tumoren

Key words

prefabrication of flaps - reconstruction of tumor defects - vacuum therapy - head and neck tumors

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Prof. Dr. J. Schipper
Leitender Oberarzt

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde

Killianstr. 5

79106 Freiburg

Phone: 07 61/2 70 42 12

Email: schipper@hno.ukl.uni-freiburg.de

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