{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T10:43:07Z","timestamp":1785580987525,"version":"3.56.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Aufgrund eines fortgeschrittenen Rektumkarzinoms kann eine\n                    Eviszeration mit Rektumamputation notwendig werden. Dabei k\u00f6nnen vor allem bei\n                    entsprechenden Voroperationen und neoadjuvanter Radiatio, ausgedehnte sowie\n                    tiefgreifende Weichteildefekte entstehen, die eine freie mikrovaskul\u00e4re\n                    Gewebetransplantation n\u00f6tig werden lassen. In dieser Fallserie zeigen wir die\n                    erfolgreiche Kombination der muskulokutanen M. vastus lateralis-Lappenplastik\n                    (MVL) mit direktem Anschluss an die A. glutealis superior.<\/jats:p><jats:p>\n          Material und Methoden Wir untersuchten \u00fcber einen Zeitraum von 47 Monaten,\n                    11 retrospektiv F\u00e4lle von Patienten, bei denen dorsale Beckendefekte nach\n                    Eviszeration und Rektumamputation bestanden, die mit lokalen oder regionalen\n                    Mitteln nicht zu verschlie\u00dfen waren. Bei all diesen Patienten erfolgte bei\n                    ausgedehnten Defekten mit tiefen pararektal Wundh\u00f6hlen eine Defektdeckung durch\n                    eine freie myokutaner MVL-Lappenplastik mit direkte Gef\u00e4\u00dfanschluss an die\n                    superioren Glutealgef\u00e4\u00dfe.<\/jats:p><jats:p>\n          Ergebnisse Die Defektgr\u00f6\u00dfe betrug im Mittel 290,0\u2009cm\u00b2 (SD: 131,2; Range:\n                    200\u2013600\u2009cm\u00b2). Die Defekttiefe betrug im Mittel 10,5\u2009cm. Die Defekte machten\n                    somit MVL-Lappenplastiken mit einer mittleren Gr\u00f6\u00dfe von 336,3\u2009cm\u00b2 notwendig. Es\n                    waren aufgrund von Nachblutungen drei operative Revisionen n\u00f6tig. Es traten\n                    weder arterielle noch ven\u00f6se Thrombosen sowie kein Lappenverlust auf. Einzig\n                    wurde eine Lappenspitzennekrose beobachtet, die sekund\u00e4r per Direktnaht\n                    korrigiert werden konnte. Die Auswertung des Case-Mix ergab einen Wert von im\n                    Mittelwert 24,251 (SD: 21,699; Range: 7,036\u201365,748) Punkten, was die Komplexit\u00e4t\n                    der F\u00e4lle unterstreicht.<\/jats:p><jats:p>\n          Schlussfolgerungen Unsere Ergebnisse zeigen, dass eine freie\n                    mikrovaskul\u00e4re MVL-Lappenplastik eine praktikable Therapieoption f\u00fcr pararektale\n                    Defekte darstellt, die nicht durch lokoregionale Methoden verschlossen werden\n                    k\u00f6nnen. Die A. glutea superior ist daf\u00fcr ein sicheres und suffizientes\n                    Anschlussgef\u00e4\u00df. In Kombination lassen sich auch ausgedehnte Defekte erfolgreich\n                    verschlie\u00dfen.<\/jats:p>","DOI":"10.1055\/a-2288-5141","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T22:47:15Z","timestamp":1713826035000},"page":"279-285","source":"Crossref","is-referenced-by-count":4,"title":["Deckung komplexer pararektaler Beckendefekte: Rolle der freien\n                    myokutanen Musculus vastus lateralis Lappenplastik"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7893-3976","authenticated-orcid":false,"given":"Wolfram","family":"Demmer","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Alt","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Mert","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Nuernberger","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"Wachtel","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Karcz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, Wiederherstellende und Handchirurgie, Zentrum\n                    f\u00fcr Schwerbrandverletzte, Klinikum N\u00fcrnberg, N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo E.","family":"Giunta","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Ehrl","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie, \u00c4shetische\n                    Chirurgie, Klinikum der Ludwig-Maximilians Universit\u00e4t, M\u00fcnchen, M\u00fcnchen,\n                    Germany"},{"name":"Klinik f\u00fcr Plastische, Wiederherstellende und Handchirurgie, Zentrum\n                    f\u00fcr Schwerbrandverletzte, Klinikum N\u00fcrnberg, N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"ref1","first-page":"90","article-title":"Therapeutic options for reconstruction of the dorsal trunk wall","volume":"46","author":"B Behr","year":"2014","journal-title":"Handchir Mikrochir Plast 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