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Titolo:
Rib harvesting - Technique and pain therapy. Introduction
Autore:
Rasp, G; Staudenmaier, R; Ledderose, H; Kastenbauer, E;
Indirizzi:
Univ Munich, Klin & Poliklin Hals Nasen Ohrenkranke, D-81377 Munich, Germany Univ Munich Munich Germany D-81377 Ohrenkranke, D-81377 Munich, Germany
Titolo Testata:
LARYNGO-RHINO-OTOLOGIE
fascicolo: 3, volume: 79, anno: 2000,
pagine: 155 -
SICI:
0935-8943(200003)79:3<155:RH-TAP>2.0.ZU;2-S
Fonte:
ISI
Lingua:
GER
Soggetto:
COSTAL CARTILAGE FRAMEWORK; DONOR-SITE MORBIDITY; CONCHA-TYPE MICROTIA; TOTAL RECONSTRUCTION; LONG-TERM; AURICLE; EAR; SURGERY; FLAP;
Keywords:
autologous transplant; rib cartilage; operating technique; local pain therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Rasp, G Univ Munich, Hals Nasen Ohren Klin, Marchioninistr 15, D-81377 Munich, Germany Univ Munich Marchioninistr 15 Munich Germany D-81377 ich, Germany
Citazione:
G. Rasp et al., "Rib harvesting - Technique and pain therapy. Introduction", LARY RH OTO, 79(3), 2000, pp. 155

Abstract

Introduction: In reconstructive surgery there is a growing demand for cartilage grafts. For small amounts of autologous tissue, cartilage from the nasal septum or ear concha is a sufficient and reliable tissue, but in cases of extensive defects or higher mechanical load autologous rib cartilage is a commonly used transplant. Nevertheless, a serious donor-site morbidity, especially postoperative pain, has to be taken into consideration. We present a modified technique for harvesting rib cartilage with a consecutive local pain therapy. Technique: In contrast to the commonly used incision through all layers of tissue the described technique follows the anatomical structures of skin tension-lines, the fascial and muscle fibers and tissue sliding-planes. Starting with a transversal skin incisions 1.5 cm above the costal arch, longitudinal splitting of the rectus abdominis fascia and muscle, the rib cartilage of the ribs 6 to 8 can be exposed. Grafts in the size of at least 3 to 8 cm can he harvested under preservation of the perichondrium. This technique causes a high degree of stability and good function of theabdominal wall. Postoperative Pain Therapy: After harvesting rib cartilagemost patients complain about extensive postoperative pain. Far adequate treatment the local application of a long-lasting anesthetic substance close to the intercostal nervs is helpful. The introduction of a peridural catheter opens the feasibility of contineously applying a local anesthetic for 3 to 4 days directly into the donor-site. This procedure reduces the need forgeneral anesthetics dramatically and prevents further complications. Discussion: This modified technique for harvesting rib cartilage diminishes the donor-site morbidity by reducing the risk of pneumothorax, hernias and functional deficits. Moreover, the local pain therapy assures postoperative wellness and mobility.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 16:41:44