脊椎腫瘍摘出術の術後感染の管理に有茎広背筋弁を用いた4例

Use of the Latissimus Dorsi Muscle Flap for Management of Surgical Site Infection Following Total En Bloc Spondylectomy. Report of Four Cases

　脊椎腫瘍摘出術の術後感染に対する予防，治療目的に，有茎広背筋弁を用いた再建術を行った．対象は当科で施行した脊椎腫瘍摘出術の166例中，有茎広背筋弁を用いた4例である．2例は術後感染のリスクが高いと考え，腫瘍摘出術と同時に，術後感染の予防目的に有茎広背筋弁を用いた．2例は術後感染例で，掻爬，洗浄などの方法では感染を沈静化できなかったため，治療目的に有茎広背筋弁を用いた．全例で術後感染の予防，治療を達成できたため，有茎広背筋弁を用いた再建術は脊椎腫瘍摘出術の術後感染に対して有効な方法であると考えた．

　We report four cases in which a latissimus dorsi muscle pedicle flap was used to prevent or treat surgical site infection after resection of a spinal tumor. In 2 cases, we used the flap to prevent surgical infection because of a high risk of infection. Infection was already present in the other 2 cases.We used the flap to treat surgical site infection because curettage and ablution methods were ineffective. Since surgical site infection was prevent or cured in all 4 cases, the latissimus dorsi muscle pedicle flaps were useful for preventing and treating surgical site infection after resection of spinal tumors.