LDT classification and therapeutic strategy of congenital body wall defects

Publication date: Available online 19 September 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Shun Wu, Ke Guo, Peng Xiao, Jiaming Sun
Part of the paper was presented at meeting previouslyWe shared the repairing methods, which were used in our 5 cases of congenital malformations, at "The Third World Congress for Plastic Surgeons of Chinese Descent" in 2012. The title of this conference paper was "Clinical Experiences on Repairing of Huge Body Wall Defects".BackgroundRepairing body wall defects is a critical step in the treatment of some congenital deformities, and this procedure may need the help from plastic surgeons. Although there are many articles about congenital deformities, body wall defects of these malformations are rarely studied as independent targets.MethodsIn this article, the authors present an LDT classification for congenital body wall defects according to the position of the defects, the tissue layers involved, and the surgical urgency, each of which is represented by letters L, D, and T, respectively. That is, the defects in different areas (L), full-thickness (D1), or partial (D0A, D0B) defects, defects needing instant repair (T2), semi-elective repair (T1), or elective repair (T0). Based on this classification system, the authors have performed body wall reconstruction on two pairs of thoraco-omphalopagus twins, one pair of ischiopagus tetrapus twins, and an infant and an adult, both of whom were diagnosed with pentalogy of Cantrell associated with ectopia cordis.ResultsExcept for one pair of thoraco-omphalopagus twins who died after emergency separation, all the other patients survived. Another pair of thoraco-omphalopagus twins suffered from wound dehiscence and partial flap necrosis, respectively, after surgery. An expanded polytetrafluoroethylene mesh in one sister of the ischiopagus twins was removed because of infection.ConclusionsLDT classification not only can help doctors categorise different congenital body wall defects rapidly and easily, but can also guide the reconstruction of these defects. It may have clinical value to plastic surgeons to some extent.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xmYWhK