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find Keyword "创面" 456 results
  • 第二指蹼动脉蒂复合组织瓣修复示中指指背组织缺损

    目的总结应用第2指蹼动脉蒂复合组织瓣修复示、中指指背复合组织缺损的疗效。 方法2007年6月-2013年7月,采用第2指蹼动脉蒂复合组织瓣修复7例机器绞伤导致的示、中指指背复合组织缺损。男5例,女2例;年龄18~55岁,平均36岁。中指3例,示指1例,示、中指均有缺损3例。受伤至入院时间6~36 h,平均15 h。软组织缺损范围2.5 cm×1.0 cm~4.5 cm×1.5 cm。第2指蹼动脉皮瓣切取范围为3.0 cm×1.5 cm~6.0 cm×2.0 cm。供区均直接缝合。 结果术后7例皮瓣均完全成活,供、受区切口均Ⅰ期愈合。患者均获随访,随访时间11~13个月,平均12个月。皮瓣外形良好,末次随访时根据中华医学会手外科学会上肢部分功能评定试用标准评定手指总主动活动度均达优。供区遗留线性瘢痕。 结论第2指蹼动脉蒂复合组织瓣修复示、中指指背复合组织缺损具有手术操作简便、疗程短、皮瓣血供可靠等优点,术后手指外观及功能良好。

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • RECONSTRUCTION OF AVULSED INJURIES OF HEEL WITH A SENSORY PREFABRICATED FLAP

    ObjectiveTo investigate the effectiveness of using a sensory prefabricated flap to repair the heel avulsion injury. MethodsBetween August 2012 and August 2013, 6 cases of heel avulsion injury were treated. There were 4 males and 2 females, aged 16-54 years (mean, 29 years). The causes were crush injury in 4 cases and wheel twist injury in 2 cases. The injury to admission time was 2-6 hours (mean, 4 hours). The size of skin avulsion ranged from 5 cm×3 cm to 15 cm×8 cm. Avulsion skin had no replanted condition. At one stage operation, the avulsed heel skin soft tissue was made the full thickness skin graft which was fostered on the anterolateral thigh with lateral circumflex femoral artery perforator, and the lateral femoral cutaneous nerve was put beneath the skin to prefabricate the prefabricated flap; at two stage operation, the prefabricated skin flap pedicled with lateral circumflex femoral artery was used to repair the wound, and the lateral femoral nerve was anastomosed with the calcaneal nerve to reconstruct the feeling. ResultsSix prefabricated flaps all survived, and re-plantation flaps survived after operation. The wounds healed by first intention at donor site and recipient site. The patients were followed up 1-2 years (mean, 1.5 years). The flaps had satisfactory appearance and soft texture. At 1 year after operation, the sensation of the flaps was S3, with two-point discrimination of 22-27 mm (mean, 24.3 mm). According to ZHANG Ming's evaluation standards, the results were excellent in 5 cases, and good in 1 case. The patients could walk normally or with weight-bearing; only linear scar formed at the donor site. ConclusionFor patients with heel soft tissue avulsion injury without replantation qualification, a sensory prefabricated flap by the avulsed heel skin soft tissue can transplanted to repair the heel defect. Satisfactory effectiveness can be obtained in heel appearance and function recovery.

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • The Application of FishnetLike Stabbing to the Flap of Breast During the Radical Mastectomy for Breast Cancer

    目的探讨皮瓣鱼网式打孔在乳腺癌根治术后创面覆盖中的应用。方法对80例女性乳腺癌患者行乳腺癌根治术或改良根治术,而后在皮瓣上、下缘予以鱼网式打孔,常规缝合创面。结果全部病例均未植皮,有15例在术后2~5天内有皮瓣血供不良,其余65例均无皮瓣坏死,创面愈合良好。结论皮瓣鱼网式打孔可有效地减小皮瓣缝合张力,减少皮瓣坏死的并发症,可应用于乳腺癌根治术的创面覆盖。

    Release date:2016-08-28 04:47 Export PDF Favorites Scan
  • 双套血供的前臂尺背侧逆行岛状皮瓣修复手部创面

    目的总结双套血供的前臂尺背侧逆行岛状皮瓣修复手部创面的临床疗效。 方法2010年3 月-2012年6月,采用带尺动脉腕上皮支和骨间背侧血管双套血供的前臂尺背侧逆行岛状皮瓣修复手部创面21例。其中男13例,女8例;年龄19~58岁,平均33.5岁。机器绞伤9例,挤压伤7例,热压伤5例。创面部位:虎口3例,手背侧12例,手掌侧6例。创面范围6 cm × 5 cm~13 cm × 10 cm。伤后至手术时间1.5 h~11 d,平均5.5 d;其中一期修复11例,二期修复10例。术中皮瓣切取范围7 cm × 6 cm~16 cm × 12 cm。 结果术后1例皮瓣以远1/3发生坏死,经二期植皮后成活;其余皮瓣及供区植皮均顺利成活,切口Ⅰ期愈合。术后14例获随访,随访时间6~18个月,皮瓣色泽、质地好,温、痛、触觉恢复。末次随访时,手功能采用中华医学会手外科学会上肢部分功能评定试用标准评定:获优8例,良4例,中1 例,差1例,优良率85.7%。供区无功能影响。 结论双套血供的前臂尺背侧逆行岛状皮瓣修复手部创面具有操作简便、可切取面积大、血运可靠、术后外观及功能恢复良好等优点。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 指动脉串联逆行岛状皮瓣修复老年指端脱套伤

    目的总结指动脉串联逆行岛状皮瓣修复老年指端脱套伤的疗效。 方法2011年6月-2012年8月,收治7例老年指端脱套伤。男5例,女2例;年龄56~68岁,平均62岁。致伤原因:冲压伤4例,机器绞伤3例。损伤指别:示指3例,中指3例,环指1例。合并末节指骨骨折2例,伸肌腱止点撕脱1例,相邻指损伤1例。伤后至手术时间为3~5 d,平均3.6 d。术中在患指切取近节指根部及掌远端2块皮瓣瓦合修复指端皮肤软组织缺损;近节指根部侧方皮瓣切取范围为1.4 cm × 1.2 cm~2.0 cm × 1.8 cm,掌远端皮瓣为1.1 cm × 1.0 cm~1.8 cm × 1.5 cm。掌远端供区直接缝合,指根部供区游离植皮修复。 结果1例掌远端皮瓣术后12 h发生静脉危象,经间断拆线后缓解;其余皮瓣及供区植皮均顺利成活,创面Ⅰ期愈合。术后7例均获随访,随访时间6~20个月,平均12个月。皮瓣外形、质地均良好。末次随访时,近节指根部侧方皮瓣两点辨别觉为7~10 mm,掌远端皮瓣为8~12 mm;手指功能参照中华医学会手外科学会上肢部分功能评定试用标准:获优6例,良1例。 结论指动脉串联逆行岛状皮瓣是利用远侧指间关节指固有动脉交通支的解剖特点,将相邻的2块皮瓣瓦合修复老年患者指端脱套伤,手术操作简便,疗效满意。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • EFFECTIVENESS OF PERICHONDRIAL CUTANEOUS GRAFT OF DORSAL AURICLE FOR REPAIRING FACIAL MELANOCYTIC NEVUS EXCISION DEFECT

    Objective To investigate and compare the effectiveness of perichondrial cutaneous graft (PCCG) of dorsal auricle for repairing defect after excision of melanocytic nevus in different parts of the face. Methods Between February 2008 and October 2012, 29 cases of facial melanocytic nevus were admitted. There were 11 males and 18 females, aged 3-25 years (median, 11 years). The locations were the upper eyelid in 5 cases, the nose in 15 cases, and the buccal region in 9 cases. The size of the nevi ranged from 1.2 cm × 1.0 cm to 4.0 cm × 2.2 cm. Defects after excision of nevi were repaired by PCCG of the dorsal auricle, which size ranged from 1.5 cm × 1.5 cm to 4.2 cm × 2.5 cm. The postoperative effectiveness was scored by patients according to color match, scar formation, and flatness of the reception site. The satisfaction evaluations were compared by the score among different parts. Results All the PCCG survived. All the patients were followed up 7-15 months (mean, 10 months). All the reception site had good color match and acceptable scar formation. The nasal part had good flatness, and the upper eyelid had poor flatness. Score comparison showed no significant difference in color match between 3 parts (P gt; 0.05). Nasal part had significantly less scar formation than buccal region and upper eyelid (P lt; 0.05), but no significant difference between buccal region and upper eyelid (P gt; 0.05). Nasal part and buccal region both had significantly better flatness than upper eyelid (P lt; 0.05), but no significant difference between nasal part and buccal region (P gt; 0.05). The overall evaluation score of nasal part and buccal region was significantly higher than that of the upper eyelid group (P lt; 0.05), and the score of the nasal part was significantly higher than that of the buccal region (P lt; 0.05). Conclusion PCCG of dorsal auricle has a good color match in repair of facial defect, especially in repair of nasal defect with good flatness and no obvious scar formation.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 改良第一趾蹼皮瓣游离移植术后供区创面的修复

    目的总结应用穿支血管蒂足内侧隐神经营养血管皮瓣修复改良第1趾蹼皮瓣游离移植后供区创面的疗效。 方法2009年5月-2012年8月,对9例手部皮肤缺损患者应用改良第1趾蹼皮瓣游离移植修复后,供区遗留3.8 cm × 3.3 cm~5.2 cm × 3.6 cm大小创面,均不能通过直接缝合或植皮修复。男7例,女2例;年龄28~56岁,平均36.2岁。创面合并第1、2趾趾伸肌腱或第1、2趾跖骨外露。手部皮肤缺损修复后一期采用大小为4.2 cm × 3.6 cm~6.0 cm × 4.0 cm的穿支血管蒂足内侧隐神经营养血管皮瓣移位修复供区创面。 结果术后9例皮瓣均顺利成活,创面Ⅰ期愈合。患者均获随访,随访时间6~13个月,平均7个月。皮瓣颜色、质地与受区周围皮肤相似。第1趾蹼夹持、伸展等功能恢复良好。术后6个月,皮瓣静态两点辨别觉达4~9 mm,平均4.8 mm;皮瓣感觉功能恢复至S3 3例,S3+ 4例,S4 2例。 结论应用穿支血管蒂足内侧隐神经营养血管皮瓣修复改良第1趾蹼皮瓣移植后供区创面可获满意疗效。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • EFFECTIVENESS OBSERVATION OF STAGED TREATMENT OF OPEN Pilon FRACTURE COMBINED WITH SOFT TISSUE DEFECT

    Objective To explore the effectiveness of staged treatment of open Pilon fracture combined with soft tissue defect. Methods Between June 2007 and December 2012, 18 cases of open Pilon fracture combined with soft tissue defect were treated. There were 14 males and 4 females with an average age of 35 years (range, 19-55 years). The causes of injury included falling from height in 12 cases, traffic accident in 4 cases, and crushing by machine in 2 cases. According to AO classification, 1 case was classified as type B2 fracture, 3 cases as type B3 fracture, 5 cases as type C1 fracture, 5 cases as type C2 fracture, and 4 cases as type C3 fracture. Sixteen cases accompanied by fibular fracture (14 cases of simple fibular fracture and 2 cases of communicated fibular fracture). According to Gustilo classification, the soft tissue injuries were all type IIIB. In first stage, debridement and vaccum sealing drainage combined with external fixation were performed; open reduction and internal fixation of simple fibular fracture were used. In second stage, open reduction and internal fixation of Pilon fracture and communicated fibular fracture were performed, and the flaps of 6 cm × 5 cm to 18 cm × 14 cm were applied to repair soft tissue defect at the same time. The donor site was repaired by skin graft. Results Partial necrosis occurred in 2 flaps, the other 16 flaps survived completely. The incisions of donor sites healed by first intention, the skin graft survived completely. The average follow-up interval was 12 months (range, 6-24 months). The X-ray films showed that the bone healing time ranged from 5 to 8 months (mean, 6 months). No internal fixation failure was found. At last follow-up, the average range of motion of the ankle joint was 37° (range, 26-57°). According to the American Orthopedic Foot and Ankle Society (AOFAS) scale, the average score was 80.2 (range, 72-86). Traumatic arthritis occurred in 2 cases (11%). Conclusion The staged treatment has the advantages of accurate evaluation of soft tissue injury, shortened cure time, good reduction of the articular surface, and reduced incidence of infection, so it is an optimal method to treat open Pilon fracture combined with soft tissue defect.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 掌部及跖部撕脱皮肤异位寄养后回植的临床研究

    目的 总结掌、跖部撕脱皮肤异位寄养后回植的方法及临床疗效。 方法2007年3月-2012年3月,收治8例掌、跖部皮肤撕脱伤患者。男5例,女3例;年龄18~50岁,平均34岁。致伤原因:交通事故伤4例,重物砸伤2例,机器绞伤2例。损伤部位:手掌2例,足跟3例,前足2例,足底1例。伤后至入院时间为1~7 h,平均4 h。皮肤撕脱范围为5 cm × 3 cm~20 cm × 10 cm。一期手术将掌、跖部撕脱皮肤寄养在股前外侧区域的深筋膜层(即预制皮瓣);二期切取预制皮瓣原位回植修复创面。 结果一期寄养术后2周3例切口有渗液,应用红光理疗仪治疗后,寄养皮片成活;其余5例寄养皮片均顺利成活。二期原位回植术后皮瓣均顺利成活,寄养部位及回植修复创面均Ⅰ期愈合。患者均获随访,随访时间6~12个月,平均7.5个月。皮瓣外形满意,质地柔软。术后6个月,皮瓣感觉达S3;两点辨别觉为20~25 mm,平均22.5 mm。手功能基本恢复,足部恢复正常行走及负重。 结论对于掌、跖部皮肤撕脱伤,经一期寄养撕脱皮肤、二期原位回植后,成活率高,保存了原掌、跖部皮肤,是重建掌、跖部功能的较好手术选择。

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • 第四腰动脉穿支皮瓣治疗骶尾部小面积褥疮

    目的总结第4腰动脉穿支皮瓣修复骶尾部小面积褥疮的疗效。 方法2002 年1月-2012年10月,采用第4腰动脉穿支皮瓣修复骶尾部小面积褥疮17例。男11例,女6例;年龄23~84岁,平均71.6岁。褥疮根据美国国家压疮专家组(NPUAP)分度标准:Ⅲ度8例,Ⅳ度9例。病程30 d~9个月,平均2.5个月。褥疮范围5 cm × 4 cm~7 cm × 5 cm。皮瓣切取范围15 cm × 8 cm~17 cm × 10 cm。供区直接缝合。 结果术后1例皮瓣边缘坏死、1例切口愈合不良合并轻度感染,均经对症治疗后愈合;其余皮瓣完全成活,创面Ⅰ期愈合。供区1例切口边缘皮肤坏死,经换药愈合;其余切口均Ⅰ期愈合。1例术后2个月余因股骨粗隆间骨折合并肺部感染死亡;余16例获随访,随访时间3 个月~2年,平均6.4个月。皮瓣质地优良,外形满意,皮肤颜色及弹性均恢复较好,术后3个月皮瓣触、痛觉与周围正常皮肤相似。褥疮无复发。 结论第4腰动脉穿支皮瓣设计简便、血供可靠、不损伤臀部肌肉、供区无需植皮,术后褥疮复发率低,是修复骶尾部小面积褥疮的有效方法之一。

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
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