Herniation after deep circumflex iliac artery flap: two cases of rare complication / 대한악안면성형재건외과학회지

Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.

Clinical Review of 'Tension Free' Inguinal Hernioplasty with Polypropylene Mesh and Bassini Type Inguinal Hernioplasty

BACKGROUND: All standard methods of hernia repair involve suturing together tissues which are not normally in apposition. This violates the basic surgical principle that tissue must never be approximated under tension and account for an unacceptable number of failures. Total reinforcement of the inguinal floor with a sheet of suitable biomaterial of a 'tension-free' technique is a more effective approach. METHODS: We have treated inguinal hernias by Bassini method in eighty-nine patients and by Lichtenstein tension free method in sixty-one patients from September, 1993 through December, 1995 and compared these two groups on age, sex, site, type anesthesia, operation time, admission date, postoperative complication, postoperative pain-killer injection period, recurrence. RESULTS: The result are as follows 1) There was no significantly difference compared Bassini method with Lichtenstein tension free method on age, sex, site, type, anesthesia, postoperative complications. 2) The average time of operation was 61.8 minutes on Bassini method and 53.6 minutes on Lichtenstein tension free method. 3) The postoperative complications were hematoma 2 cases, wound seroma 1 case on Bassini method, and wound seroma 1 case on Lichtenstein tension free method. 4) The average duration in the hospital stay after operation was 6.01 days on Bassini method and 4.75 days on Lichtenstein tension free method (p<0.01). 5) The average period for injection of pain-killer after operation was 3.61 days on Bassini method and 2.21 days on Lichtenstein tension free method (p<0.01). 6) The recurrence rate was 6 cases(6.7%) on Bassini method and no recurrence case on Lichtenstein tension free method (p<0.05). CONCLUSIONS: We conclude that Lichtenstein tension free method is less painful and shorter postoperative hospital stay than Bassini method.