Usefulness of Omental Flap for Various Soft Tissue Reconstruction

다양한 연부조직 재건에서의 대망피판의 유용성

  • Lee, Hwa Seob (Department of Plastic & Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Park, Sae Jung (Department of Plastic & Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Ryu, Hyung Ho (Department of Plastic & Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Suh, Man Soo (Department of Plastic & Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Lee, Dong Gul (Department of Plastic & Reconstructive Surgery, Kyungpook National University College of Medicine) ;
  • Chung, Ho Yun (Department of Plastic & Reconstructive Surgery, Kyungpook National University College of Medicine) ;
  • Park, Jae Woo (Department of Plastic & Reconstructive Surgery, Kyungpook National University College of Medicine) ;
  • Cho, Byung Chae (Department of Plastic & Reconstructive Surgery, Kyungpook National University College of Medicine)
  • 이화섭 (대구파티마병원 성형외과) ;
  • 박세정 (대구파티마병원 성형외과) ;
  • 류형호 (대구파티마병원 성형외과) ;
  • 서만수 (대구파티마병원 성형외과) ;
  • 이동걸 (경북대학교병원 의과대학 성형외과학교실) ;
  • 정호윤 (경북대학교병원 의과대학 성형외과학교실) ;
  • 박재우 (경북대학교병원 의과대학 성형외과학교실) ;
  • 조병채 (경북대학교병원 의과대학 성형외과학교실)
  • Received : 2005.04.15
  • Published : 2005.07.10

Abstract

Extensive and complicated defects on the body call for an omnipotent tool for a perfect reconstruction. Flaps derived from the omentum has many advantages over the conventional flaps. From 1999 to 2004, Omental flaps were applied for various soft tissue reconstructions. Among total 20 total 7 cases were for immediate reconstruction, 2 cases for chronic infection, 3 cases for simultaneous reconstruction of two defects, 4 cases for functional joint reconstruction and 4 cases were for flow- through revascularization. Among these cases, 3 cases were operated with minimal incision harvest technique. There were no complete flap failures, partial necrosis of the distal parts were noted on three cases. The omental flap is indicated on a large contaminated defect reconstruction due to its large size, well-vascularized, and malleable properties. The omental flap provides several additional advantages over other flaps, which are; the availability of the one staged simultaneous reconstruction of two defects with one flap, providing gliding function for the joint motion, and a flow-through characteristics with long vascular pedicle. But there are some serious shortcomings, including a long abdominal scar and intraabdominal problems. However, these are rare and can be minimized with our minimal incision technique. Due to its unique characteristics. the omentum is one of the ideal tissues for the reconstruction of the complicated soft tissue defects due to its unique characteristics.

Keywords

References

  1. Mclean DH, Buncke HJ: Autotransplant of omentum to a large scalp defect, with microsurgical revascularization. Plast Reconstr Surg 49: 268, 1972 https://doi.org/10.1097/00006534-197203000-00005
  2. Goldsmith HS, Saunders RL, Reeves AG, Allen CD, Milne J: Omental transposition to brain of stroke patients. Stroke 10: 471, 1979 https://doi.org/10.1161/01.STR.10.4.471
  3. Yoshioka N, Tominaga S, Suzuki Y, Yamazato K, Hirano S, Nonaka K, Inui T, Matuoka N: Cerebral revascularization using omentum and muscle free flap for ischemic cerebrovascular disease. Surgical Neurology 49: 58, 1998 https://doi.org/10.1016/S0090-3019(97)00122-5
  4. Upton J, Mulliken JB, Hicks PD, Murray JE: Restoration of facial contour using free vascularized omental transfer. Plast Reconstr Surg 66: 560, 1980 https://doi.org/10.1097/00006534-198010000-00009
  5. Sugawara Y, Harii K, Yamada A, Hirabayashi S, Sakurai A, Sasaki T: Reconstruction of skull defects with vascularized omentum transfer and split cavarial bone graft: two cases reports. J Reconstr Microsurg 14: 101, 1998 https://doi.org/10.1055/s-2007-1000151
  6. Kusiak JF, Rosenblum NG: Neovaginal reconstruction after exenteration using an omental flap and split-thickenss skin graft. Plast Reconstr Surg 97: 775, 1996 https://doi.org/10.1097/00006534-199604000-00013
  7. Ueda K, Harashina T, Harada T, Oba S, Nagasaka S: Omentum as gliding material after extensive forearm tenolysis. Br J Plast Surg 46: 590, 1993 https://doi.org/10.1016/0007-1226(93)90112-O
  8. Koh KS, Leem PJ, Park SH, Lee TJ, Yoon KC: Microvascular free tissue transfer for aesthetic facial contouring. J Korean Soc Plast Reconstr Surg 27: 276, 2000
  9. Park BS, Lee JI, Chung CH, Oh SJ: Reconstruction of the large scalp defect with free flap. J Korean Soc Plast Reconstr Surg 21: 1168, 1994
  10. Hultman CS, Culbertson JH, Jones GE, Losken A, Kumar AV, Carlson GW, Bostwick J, Jurkiewicz MJ: Thoracic reconstruction with the omentum: indications, complications, and results. Ann Plast Surg 46: 242, 2001 https://doi.org/10.1097/00000637-200103000-00007
  11. Kamei Y, Torii S, Hasegawa T, Nishizeki O: Endoscopic omental harvest. Plast Reconstr Surg 102: 2450, 1998 https://doi.org/10.1097/00006534-199812000-00030