METHOD OF REPLACING FENESTRATED TRACHEAL AND LARYNGEAL DEFECTS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to field of medicine, namely to reconstructive-restorative surgery and otolaryngology, and can be applied in replacement of fenestrated tracheal and laryngeal defects. Method includes sampling and formation of free revascularisable cutaneous-fascial autotransplant with its further sewing into defect with skin inwards with support of rigid component against anterior and lateral walls of defect, recovery of blood supply in autotransplant. In formed autotransplant cutaneous part corresponds to defect dimensions. Flap of subcutaneous adipose cellular tissue and superficial fascia exceeds it by 5-10 mm. Onto fascial surface of autotransplant laid is mesh implant with cell size 200-500 mcm, projecting beyond autotransplant edges by not less than 10 mm. Implant is woven from superelastic nickelide-titanium thread with diameter 60-90 mcm. Linear cut is made in implant and supplemented by cutting out circular hole for placement of autotransplant vascular pedicle. After that, it is fixed through tissue thickness to autotransplant skin with superelastic nickelide-titanium thread with diameter 40-60 mcm. Knots are tied up on implant surface. After that, reinforced with mesh implant autotransplant is placed into defect and autotransplant skin is fixed to trachea and/or larynx defect edges with further covering of suture line with autotransplant tissues. Projecting edge of mesh implant, from composition of formed autotransplant, is fixed to trachea and/or larynx walls.;EFFECT: application of said invention makes it possible to eliminate fenestrated tracheal and laryngeal defects of any size by means of autotransplant which is well-supplied by blood with minimal anatomical-functional or cosmetic damage for donor zone, simplify surgeon's actions and reduce operation trauma.;2 ex, 3 dwg