A new composite gastric seromuscular and omental pedicle flap.
OBJECTIVE
The authors performed a study to see if gastric seromuscular patch elevation is anatomically feasible and to estimate the maximum size of the patch relative to its blood supply.


BACKGROUND
A flap composed of greater omentum and a full-thickness segment of the greater curvature of the stomach, based on the right gastroepiploic artery, was first described in 1977. Elevation of the greater omentum along with a seromuscular patch of stomach has not been reported previously.


METHODS
Angiography was performed via the right gastroepiploic artery in a stomach obtained from ten patients who underwent gastrectomy, then india ink was injected. The stomach was then fixed in 10% formalin, and histochemical examination was performed to determine if seromuscular patch elevation was possible.


RESULTS
Results of the angiography and injection experiment of india ink indicated that the territory of a single gastric ramus was approximately 5 cm x 5 cm in both anterior and posterior walls of the stomach. Histology revealed that the gastric rami lay between the muscular layer and the mucosa.


CONCLUSIONS
The authors believed that a composite gastric seromuscular patch and omental pedicle flap would be clinically applicable. The authors also believed that the maximum size of the patch was 10 cm x 10 cm. They used this flap to successfully treat three patients with chronic soft-tissue defects--two bronchopleural fistulae and a radiation ulcer.
Department of Plastic and Reconstructive Surgery, Nagoya University School of Medicine, Japan.
Y
Y
Kamei
S
S
Torii
D000368:Aged; D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery; D005260:Female; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery*; D012883:Skin Ulcer / Q000209:etiology / Q000601:surgery*; D013270:Stomach / Q000637:transplantation; D013524:Surgical Flaps / Q000379:methods*