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find Author "伍俊良" 8 results
  • Comprehensive Treatment for Intractable Ulcers with Infection after Pacemaker Implantation

    【摘要】 目的 探讨起搏器植入术后并发局部慢性溃疡伴感染的综合治疗方法。 方法 2005年1月-2010年5月,收治4例心脏起搏器植入术后并发局部慢性溃疡伴感染的患者。男3例,女1例;年龄3~79岁。心脏起搏器植入术后囊袋感染致皮肤破溃伴慢性溃疡2例,起搏器植入后局部张力过高所致局部慢性溃疡2例,其中2例患有2型糖尿病。所有患者均经过长期严格换药保守治疗3个月以上。手术彻底切除感染创面及相关包囊并尽可能剪除部分导丝,甚至更换导丝,根据情况原位或异位植入起搏器,并放置橡皮引流条,应用敏感抗生素5~7 d防治感染。术后2周拆线,主要观察患者切口对合情况,是否存在红肿、硬结、血肿、积液或化脓情况。 结果 4例患者术后均Ⅰ期愈合;4例均获随访,随访时间7~11个月,平均9个月。原创面愈合好,无感染及溃疡发生。 结论 通过外科手术综合治疗难治性心脏起搏器植入术后并发症,能取得满意疗效。【Abstract】 Objective To explore comprehensive treatment options for local chronic ulcer with infection after the pacemaker implantation. Methods From January 2005 to May 2010, four patients (3 males and 1 female; 3-79 years old) with intractable ulcer with infection after pacemaker implantation were admitted. Pacemaker pocket infection induced chronic ulcer was in two, and tension induced chronic ulcers were in two. Two of the four patients were type II diabetes. All of the four patients underwent strict conservative treatment at least for 3 months prior to surgical treatment. Surgical treatment involved complete excision of infected tissue surrounding the pacemaker pocket and removal of all unnecessary lengths of pacemaker lead, even complete replacement of the original lead. Depending on the specific situation, pacemakers were either placed in their original position or a new position with a latex drainage strip. Patients then received a course of antibiotic treatment ranging from 5 to 7 days. Results All of the four patients achieved healing by first intention, and were followed up for 7-11 months, with an average of 9 months follow up. All patients achieved the satisfactory results. Conclusion A comprehensive treatment is effective on local chronic ulcer with infection after the pacemaker implantation.

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • 直接削除法治疗鼻赘型酒糟鼻疗效

    目的总结直接削除法治疗鼻赘型酒糟鼻的疗效。方法2015 年 1 月—2017 年 3 月,收治 6 例鼻赘型酒糟鼻男性患者。患者年龄 45~76 岁,平均 65 岁。病程 10~18 年,平均 15 年。术中以病变周边正常皮肤为参考平面削除赘生组织,并塑形鼻部各美学亚单位。术后创面隔天换药直至完全愈合。结果6 例创面顺利愈合。患者均获随访 6 个月。鼻部瘢痕无明显挛缩,鼻部各美学亚单位均保留,病变未复发。患者均对鼻部外形满意。结论直接削除法治疗鼻赘型酒糟鼻简单有效、易于掌握,术后鼻部外形较好,患者满意度高。

    Release date:2018-05-02 02:41 Export PDF Favorites Scan
  • 皮下蒂皮瓣在面部肿瘤切除术后创面修复中的应用

    目的探讨采用皮下蒂皮瓣修复面部肿瘤切除术后创面的临床经验。 方法回顾性分析 2008 年1 月-2013 年 1 月收治的 60 例面部皮肤肿瘤患者,其中脂溢性角化症 12 例,角化棘皮瘤 6 例,色素痣 10 例,基底细胞癌 30 例,鳞状细胞癌 2 例。切除术后创面面积最小者为 0.5 cm×0.5 cm,位于右鼻翼,为色素痣切除术后创面;最大者为 6 cm×5 cm,位于鼻背部,为基底细胞癌切除术后创面。采用皮下蒂皮瓣修复面部皮肤肿瘤切除术后创面。 结果60 例患者均顺利完成手术,术中出血少。术后未发生感染。除 1 例患者术后皮瓣远端轻度缺血,形成薄痂,术后 10 d 痂壳脱落后伤口愈合,其余患者的伤口均获一期愈合。术后随访 3 个月~5 年,无肿瘤复发,皮瓣形态良好,无明显瘢痕。 结论彻底切除、及时修复、获得良好外观是面部肿瘤切除术后创面修复的关键。由于面部血循环丰富,皮下蒂皮瓣为面部肿瘤切除术后创面修复的首选。

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  • TREATMENT OBSERVATION OF NASAL TIP DEFECTS RECONSTRUCTED BY BILOBED FLAPS AFTER GAINT NEVI EXCISION

    ObjectiveTo discuss a reliable and aesthetic surgery method for the reconstruction of large defects on the top of nose after giant nevi resection. MethodsBetween January 2011 and June 2015, 46 cases of nasal tip defects caused by giant nevi resection were treated. Of 46 cases, 22 were male and 24 were female, aged 15-59 years (median, 28 years). The right ala nasi was involved in 28 cases, the apex nasi in 8 cases, and the left ala nasi in 10 cases. The diameters of nevi were from 8 to 12 mm (mean, 9.75 mm); no alar cartilage was invaded. Hair growth was seen in 14 cases. The duration of nasal nevi was from 3 years to 49 years (mean, 9.8 years). There were 9 recurrent patients who received laser therapy before surgery. The defects sizes after excision were from 10 mm×10 mm to 14 mm×14 mm. The bilobed flaps were used for one-stage reconstruction, which sizes were from 11 mm×10 mm to 15 mm×14 mm and from 10 mm×10 mm to 15 mm×14 mm. ResultsAll the incisions healed by first intention, and the flaps survived. No complication of intracranial hemorrhage or subdural hemorrhage occurred. The patients were followed up 6 months to 5 years (mean, 18 months). The appearance of nasal tip and nasolabial fold was satisfactory, and no recurrence was found during follow-up. ConclusionOne-stage bilobed flap reconstruction for nasal tip defects after giant nevus resection is one of the effective, safe, and aesthetic surgery methods.

    Release date:2016-11-14 11:23 Export PDF Favorites Scan
  • 耻骨上区瘢痕疙瘩的治疗体会

    目的总结耻骨上区瘢痕疙瘩治疗经验及体会。方法2014 年 1 月—2015 年 12 月,收治 21 例耻骨上区瘢痕疙瘩患者。男 6 例,女 15 例;年龄 11~69 岁,中位年龄 39 岁。病因:会阴部毛囊炎迁延刺激形成瘢痕疙瘩 16 例,外伤或者腹部手术后增生 5 例。病程 8 个月~21 年,中位时间 3.5 年。7 例为复发患者。15 例瘢痕疙瘩伴感染病灶。瘢痕疙瘩范围为 6.0 cm×3.5 cm~14.0 cm×7.0 cm。手术切除瘢痕疙瘩后,切取大小为 8 cm×5 cm~16 cm×8 cm 的髂腹股沟皮瓣修复创面;术后联合电子射线治疗(连续 3 d,总剂量 15 Gy)。结果术后皮瓣均成活。1 例供区愈合不佳,经换药 2 周后愈合。患者均获随访,随访时间 12~24 个月,平均 16 个月。随访期间 4 例复发,治愈率为 81%。复发患者中,2 例为初次治疗患者,2 例为再次复发;复发患者经长期瘢痕内注射曲安奈德后不同程度萎缩,并得到控制。结论对于耻骨上区瘢痕疙瘩,手术切除后采用髂腹股沟皮瓣修复,具有手术操作简便且供区切口隐蔽的优点;结合术后早期电子射线照射可以有效降低瘢痕疙瘩的复发率。

    Release date:2018-07-12 06:19 Export PDF Favorites Scan
  • CLINICAL OBSERVATION OF MODERATE TO SEVERE BLEPHAROPTOSIS CORRECTION WITH ARC-SHAPED FRONTALIS APONEUROSIS FLAP

    ObjectiveTo evaluate the effectiveness of an arc-shaped frontalis aponeurosis flap for the treatment of moderate to severe blepharoptosis. MethodBetween January 2011 and December 2014, 80 cases (140 eyes) of moderate to severe blepharoptosis were treated, including 31 males and 49 females with a median age of 16 years (range, 6-45 years). One eye was involved in 20 cases and both eyes in 60 cases. Upper eyelid ptosis degree ranged from 3 to 6 mm (average, 5 mm) when looking at the front horizontally. Fifty-one patients had underwent plastic surgery, and the first operation was performed in others. The arc-shaped frontalis aponeurosis flap was created by incision of upper and middle edge of the eyebrow, then it was retracted to the upper eyelid aponeurosis and was fixed in a slight over-correction position. ResultsThe operation was completed smoothly. The intraoperative blood loss was 5-10 mL (mean, 7 mL). Mild swelling of incision was observed after operation, and disappeared at 3-5 days after operation. Primary healing of incision was obtained, with no complications of infection and flap necrosis. The follow-up duration was 1-3 years (mean, 1.5 years). Seventy-nine cases could close upper eyelid completely and the function of upper eyelid was satisfactory within 3 months. One patient could not close upper eyelid completely after 6 months, and mild keratitis occurred, which was cured by anchyloblepharon. ConclusionsThe arc-shaped frontalis aponeurosis flap can be regarded as a minimally invasive procedure for the treatment of congenital moderate to severe blepharoptosis, it was safe, reliable, and easy-to-grasp.

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  • Application of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy

    ObjectiveTo explore the effectiveness of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy.MethodsBetween January 2016 and May 2017, 15 patients of severe breast hypertrophy had undergone breast reduction using inferior pedicle technique with inverted T pattern combined with dermal suspension sling technique. The patients were 20 to 49 years old, with an average age of 31.6 years. Body mass index ranged from 24.9 to 32.5 kg/m2, with an average of 30.8 kg/m2. Among them, 11 cases had a history of childbearing. The degree of breast ptosis was rated as degree Ⅱ in 6 cases and degree Ⅲ in 9 cases. The unilateral breast reduced 615 g on average (range, 480-1 050 g).ResultsThe skin flap necrosis at the " T” trilateral junction occurred in 3 cases, and healed after dressing changes. The incisions of 12 cases healed and no fat liquefaction, hematoma, or seroma occurred. The sensation of nipple and areola declined at early period after operation in 2 cases, and gradually recovered. All patients were followed up 6-18 months (mean, 13 months). The shapes of bilateral breasts and the height and symmetry of nipple-areolar complex were good, and no obvious scar was found. The effectiveness was evaluated by surgeon and showed that there were 12 cases with satisfactory breast shape and 3 cases with unsatisfactory breast shape; 3 cases with obvious scare and 12 cases with insignificant scar; 13 cases with normal nipple sensation and 2 cases with hypoesthesia; 11 cases with symmetric nipples and 4 cases with asymmetric nipples. The effectiveness was evaluated by patients and showed that the satisfactory breast shape in 10 cases, relatively satisfactory breast shape in 4 cases, and unsatisfactory breast shape in 1 case; highly acceptable scar in 9 cases, moderately acceptable scar in 4 cases, and unacceptable scar in 2 cases; overall satisfactory in 10 cases, relatively satisfactory in 4 cases, and unsatisfactory in 1 case, with the overall satisfaction rate of 93.3% (14/15).ConclusionFor severe breast hypertrophy, the modified inferior pedicle technique with inverted T pattern can obtain satisfactory appearance and avoid the mastoptosis.

    Release date:2019-03-11 10:22 Export PDF Favorites Scan
  • Effectiveness of internal mammary artery perforator propeller flap repair combined with radiotherapy for chest keloid in female patients

    ObjectiveTo investigate the effectiveness of internal mammary artery perforator (IMAP) propeller flap repair combined with radiotherapy for chest keloid in female patients.MethodsBetween January 2015 and December 2016, 15 female patients with chest keloids were treated, aged 28-75 years (mean, 45.2 years). The keloid disease duration was 1-28 years (median, 6 years). The causes of disease included secondary keloid caused by folliculitis in 7 cases, cardiac surgery in 4 cases, skin abrasion in 2 cases, mosquito bite in 1 case, and unknown etiology in 1 case. The size of keloid ranged from 5 cm×3 cm to 17 cm×6 cm. The IMAP propeller flaps were used to repair the defects after chest keloid excision. The size of flaps ranged from 7 cm×5 cm to 14 cm×8 cm. The donor sits were sutured directly. The routine radiotherapy was performed after operation.ResultsAll IMAP propeller flaps survived well, and the donor sites healed by first intention. All 15 patients were followed up 12-24 months (mean, 16 months). No telangiectasia or incision dehiscence occurred. No radiation-related carcinogenesis occurred during follow-up. The patients were satisfied with the breast shape and symmetry after operation. The symptoms of pain and itching relieved at keloid area in 13 cases (86.7%), with no obvious recurrence of keloid at the donor site and the primary site. Only 2 cases (13.3%) recurred and were treated with continuously conservative treatment.ConclusionIMAP propeller flap is an ideal reconstruction method for repairing the wounds after chest keloid excision in female patients, which can preserve the good breast shape. The IMAP propeller flap repair combined with early postoperative radiotherapy can effectively reduce the recurrence rate, and the effectiveness is satisfactory.

    Release date:2018-09-03 10:13 Export PDF Favorites Scan
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