{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T23:47:10Z","timestamp":1764028030073,"version":"3.45.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Versorgung von Rumpfwanddefekten kann im klinischen Alltag eine Herausforderung darstellen, insbesondere, wenn konventionelle Ma\u00dfnahmen wie direkte Wundverschl\u00fcsse oder Hauttransplantationen aufgrund von Defektgr\u00f6\u00dfe und -tiefe, Lokalisation oder mangels ad\u00e4quatem Haut-Weichteil-Mantel nicht ausreichen. Perforatorbasierte lokale Lappenplastiken haben sich in den letzten Jahren als muskelschonende Alternativen zu klassischen lokalen (myokutanen) Lappenplastiken oder freien mikrochirurgischen Lappenplastiken etabliert. Gerade im Bereich des R\u00fcckens stehen aufgrund der Gef\u00e4\u00dfanatomie h\u00e4ufig keine geeigneten Anschlussgef\u00e4\u00dfe f\u00fcr freie Lappenplastiken zur Verf\u00fcgung. Gleichzeitig bieten perforatorbasierte Lappenplastiken im Vergleich zu herk\u00f6mmlichen lokalen Lappenplastiken (\u201eRandom-Pattern\u201c-Lappenplastiken) eine erh\u00f6hte Sicherheit, da sie auf gezielten Gef\u00e4\u00dfperforatoren basieren. Dadurch lassen sie sich \u00fcber das klassische L\u00e4ngen-Breiten-Verh\u00e4ltnis von 2\u00a0:\u00a01 hinaus gestalten und\n      erm\u00f6glichen eine gr\u00f6\u00dfere Reichweite bei verbesserter Durchblutung. Durch die Nutzung perforierender Gef\u00e4\u00dfe kann zudem funktionstragende Muskulatur gr\u00f6\u00dftenteils geschont werden, was postoperativ zu einer geringeren Morbidit\u00e4t und schnelleren Rehabilitation f\u00fchren kann.Dieser Artikel richtet sich an chirurgisch t\u00e4tige Kollegen ohne spezielle plastisch-rekonstruktive Ausbildung, die dennoch regelm\u00e4\u00dfig mit komplexen Wundsituationen konfrontiert sind \u2013 etwa im Rahmen von Tumorresektionen, chronischen Infekten, Dekubitalulzera oder postoperativen Wundheilungsst\u00f6rungen. Ziel ist es, einen praxisnahen \u00dcberblick \u00fcber die Grundprinzipien, Einsatzm\u00f6glichkeiten und Grenzen perforatorbasierter lokaler Lappenplastiken zu geben. Neben einer Einf\u00fchrung in die zugrunde liegende Gef\u00e4\u00dfanatomie (Angiosom- und Perforasom-Theorie) werden pr\u00e4operative diagnostische Verfahren, verschiedene Lappentechniken und typische klinische Verl\u00e4ufe inkl. m\u00f6glicher chirurgischer Komplikationen\n      dargestellt.Ein besonderer Fokus liegt auf der Auswahl geeigneter Lappenplastiken anhand der Defektlokalisation und vorhandener ortsst\u00e4ndiger Perforatoren, mit dem Ziel, eine m\u00f6glichst einfache, sichere und nachhaltige Weichteildeckung zu erm\u00f6glichen. Klinische Fallbeispiele illustrieren exemplarisch das operative Vorgehen in unterschiedlichen Regionen der Rumpfwand.<\/jats:p>","DOI":"10.1055\/a-2636-2764","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T22:46:51Z","timestamp":1755557211000},"page":"502-510","source":"Crossref","is-referenced-by-count":0,"title":["Gestielte perforatorbasierte Lappenplastiken zur Rekonstruktion bei Defekten der Rumpfwand"],"prefix":"10.1055","volume":"150","author":[{"given":"Selim","family":"Atay","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Daigeler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joerg","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Eberhard Karls University T\u00fcbingen Faculty of Medicine, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudius","family":"Illg","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladyslav","family":"Kavaka","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Lauer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Rachunek-Medved","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Steiner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0261-8352","authenticated-orcid":false,"given":"Johannes Tobias","family":"Thiel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Klinik T\u00fcbingen, T\u00fcbingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/0007-1226(89)90075-1","article-title":"Inferior epigastric artery skin flaps without rectus abdominis muscle","volume":"42","author":"I Koshima","year":"1989","journal-title":"Br J Plast Surg"},{"key":"ref2","volume-title":"Essentials of plastic Surgery","author":"JE Janis","year":"2022","edition":"3"},{"volume-title":"Reconstructive Surgery: Anatomy, Technique, and clinical Application","year":"2012","author":"M Zenn","key":"ref3"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/0007-1226(87)90185-8","article-title":"The vascular territories (angiosomes) of the body: experimental study and clinical applications","volume":"40","author":"GI Taylor","year":"1987","journal-title":"Br J Plast Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1097\/PRS.0b013e3181b98a6c","article-title":"The perforasome theory: vascular anatomy and clinical implications","volume":"124","author":"M Saint-Cyr","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.anplas.2020.06.009","article-title":"Lower limb perforator flaps: Current concept","volume":"65","author":"B Chaput","year":"2020","journal-title":"Ann Chir Plast Esthet"},{"volume-title":"Reconstructive Surgery: Principles, Anatomy & Technique. 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