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find Keyword "双叶皮瓣" 9 results
  • 尺动脉腕上皮支双叶游离皮瓣修复手指复杂创面

    目的 总结尺动脉腕上皮支双叶游离皮瓣修复手指复杂创面的方法和临床效果。 方法 2009年5 月-2012年5月,对12例手指复杂创面患者采用以尺动脉腕上皮支为蒂,分别以其上行支和下行支为轴心血管的双叶游离皮瓣修复。其中男7例,女5例;年龄20~45岁,平均31岁。手指脱套伤2例,相邻两指软组织缺损4例,一指两处缺损6例。缺损范围6.0 cm × 1.5 cm~10.0 cm × 3.0 cm。皮瓣切取范围为上叶5.0 cm × 2.0 cm~8.0 cm × 4.0 cm,下叶3.5 cm × 1.8 cm~6.0 cm × 3.0 cm。供区直接缝合或游离植皮修复。 结果 1例术后12 h出现动脉危象,1例上叶皮瓣远端表皮部分坏死,经相应处理后愈合;其余皮瓣及供区植皮均顺利成活,切口Ⅰ期愈合。11例获随访,随访时间6~18个月,平均11个月,皮瓣颜色及质地与周围正常皮肤相似,手指外形满意。手指恢复部分浅感觉,两点辨别觉为6~8 mm,平均7 mm。术后6个月,按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7例,良3例,中1例,优良率90.9%。 结论 尺动脉腕上皮支的上、下行支管径与指血管匹配,以此为蒂的双叶游离皮瓣修复后外观、感觉恢复满意,是修复手指复杂创面的理想方法之一。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 游离双侧双叶骨间背动脉穿支皮瓣修复四指掌侧皮肤缺损一例

    目的 总结1例应用游离双侧双叶骨间背动脉穿支皮瓣修复4指掌侧皮肤缺损的方法及疗效。 方法2011年10月收治1例35岁左手机器绞伤男性患者,清创后示、中、环、小指掌侧皮肤软组织缺损范围为5.0 cm × 2.5 cm~10.0 cm × 3.0 cm,采用大小为6.0 cm × 3.0 cm~10.0 cm × 3.5 cm的游离双侧双叶骨间背动脉穿支皮瓣修复创面。供区游离植皮修复。 结果术后皮瓣及植皮均成活,创面Ⅰ期愈合。患者获随访7个月,皮瓣外形、质地良好。末次随访时示、中、环、小指关节主动活动度分别为210、90、90、70°。 结论游离双侧双叶骨间背动脉穿支皮瓣修复4指掌侧皮肤软组织缺损可获得较好近期疗效。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • REPAIRING DEGLOVING INJURY OF DISTAL PHALANX WITH HOMODIGITAL BILOBED FLAPS TILED

    Objective To study the methods and effectiveness of repairing degloving injury of the distal phalanx with homodigital bilobed flaps tiled. Methods Between April 2008 and June 2011, 40 patients (40 fingers) with degloving injury of the distal phalanx were treated, which were caused by machine. There were 30 males and 10 females, aged from 18 to 56 years(mean, 30 years). The time from injury to operation was 1-5 hours (mean, 2.5 hours). Affected fingers included index in 13cases, middle finger in 11 cases, ring finger in 9 cases, and l ittle finger in 7 cases. The defect area ranged from 3.0 cm × 2.0 cm to 5.5 cm × 3.8 cm. All cases complicated by pollution and exposure of tendon and phalanx, 5 cases by phalangeal fractures, and tendon insertion had no rupture. The end dorsal branches of digital artery island flaps and digital arterial island flaps were used in 14 cases, the end dorsal branches of digital artery island flaps and near dorsal branches of digital artery island flaps in 18 cases, and the end dorsal branches of digital artery island flaps and superficial palmar digital veins arteril ization island flaps in 8 cases. The area of the upper flaps ranged from 2.0 cm × 1.5 cm to 2.6 cm × 2.2 cm and the area of the next leaf flaps ranged from 2.5 cm × 2.0 cm to 3.5 cm × 2.5 cm. The donor sites were covered with free flaps. Results Flap bl ister occurred in 13 cases and vascular crisis in 3 cases. The flaps survived in 40 cases, wound healing by first intention was achieved in 38 cases, and by second intention in 2 cases. The donor skin-grafting was survival. After operation, 30 patients were followed up 8 to 20 months with an average of 10.6 months. The flaps had satisfactory appearance and soft texture, and the finger tip had no touch pain. The sensory function of the flaps was restored at 4-6 weeks after operation; two-point discrimination was 6.0 to 10.0 mm in 24 flaps at 12-15 months. According to the total active movement (TAM) evaluation system introduced by the American Society for Surgery of the Hand in 1975, the results were excellent in 27 cases, good in 2 cases, and fair in 1 case, and the excellent and goodrate was 96.7%. Conclusion The homodigital bilobed flaps tiled for degloving injury of the distal phalanx is simple and easyto- operate with less injury.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • DUMBBELLSHAPED DOUBLELEAF FLAP FOR THE REPAIR OF PENET RATING WOUND OF PALM WITH TISSUE DEFECT

    The penetrating wound of palm with the defect of tissues was usually caused by blunt crushing of gun-shot injury. It was difficult to treat clinically. In order to repair the skin defect of palm and dorsum in one operation, 2 kinds of dumbbell-shaped double-leaf flap were desigened. From February 1993 to March 1996, 5 cases with penetrating wound of palm were treated by this method in which the interosseous posterior artery flap in 4, and the superficial epigastric flap in 1. There were 4 males and 1 female with the ages ranging from 15 to 47 years old. The results were as follows: total survival of the flap in 4 cases and partial necrosis of skin margin of the distal leaf in 1 case. The appearance and function of the flap were satisfactory after a follow-up from 4 months to 3 years. It was concluded that the interosseous posterior artery flap had a long vascular pedicle with its constant anatomical distribution, and the 2nd stage of division of the pedicle of the flap was not necessary. It was a perfect flap in repairing the penetrating wound of the palm with small skin defect. The superficial epigastric flap was cumbersome in appearance and was necessary to divide the pedicle of the flap in 2nd staged operation. It was suitable in repairing the penetrating wound with large skin defect. Regarding the operative technique, a meticulous debridement and the appropriate flap area were required, and the blood vessel of the flap should not be compressed by the surrounding tissues. The advantages of this operation provided a simple method to handle, high rate of survival, and one-staged operation.

    Release date:2016-09-01 11:08 Export PDF Favorites Scan
  • APPLICATION OF FREE BILOBED MEDIAL SURAL ARTERY PERFORATOR FLAP FOR REPAIRING PENETRATING WOUND OF FOOT

    ObjectiveTo explore the effectiveness of the free bilobed medial sural artery perforator (BMSAP) flap to repair penetrating wound of the foot. MethodsBetween April 2012 and October 2014, 7 cases of foot penetrating wounds were treated with the BMSAP flap. There were 5 males and 2 females, aged from 21 to 43 years (mean, 31.5 years). The causes of injury included the crush injury (4 cases), blunt puncture (2 cases), and firearm injury (1 case). The wound was located at the left foot in 4 cases and at the right foot in 3 cases. There were longitudinal penetrating injury in 5 cases and transverse penetrating injury in 2 cases. The size of wound ranged from 4 cm×3 cm to 9 cm×7 cm. The interval between injury and admission was 0.5-5.5 hours (mean, 3.2 hours). The free BMSAP flap of 5 cm×4 cm-10 cm×8 cm in size was used to repair the wounds on both sides and to reconstruct the sensation. The donor site was sutured or repaired with skin graft. ResultsAfter operation, 1 case had distal flap necrosis, the flap survived after dressing change; 1 case had wound infection, and delayed healing was obtained after drainage; and the flap survived completely, and primary healing was obtained in the other 5 cases. The skin grafts survived and healing of incision by first intention was observed at donor sites. The patients were followed up from 7 to 24 months (mean, 12.5 months). The flap had soft texture and similar color to normal skin. According to the British Medical Research Council (BMRC) sensory function assessment system, 1 case was rated as S2, 4 cases as S3, and 2 cases as S3+. The American Orthopaedic Foot and Ankle Society (AOFAS) score was 86-97 (mean, 93.6); the results were excellent in 6 cases and good in 1 case. ConclusionThe free BMSAP flap is very suitable to repair penetrating wound of the foot. The flap has the advantages of repairing the two wounds at the same time and reconstructing skin sensation as well.

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  • 改良邻指双叶皮瓣修复指掌侧大面积皮肤缺损

    目的总结采用改良邻指双叶皮瓣修复指掌侧大面积皮肤软组织缺损的疗效。 方法2004年3月-2013年5月,采用改良邻指双叶皮瓣修复23例(23指)指掌侧大面积皮肤软组织缺损。男19例,女4例;年龄23~38岁,平均28.5岁。致伤原因:挤压伤12例,锐器伤6例,绞伤2例,高压灌注伤3例。损伤指别:示指13例,中指8例,环指2例。18例为外伤急诊入院,伤后至手术时间2~6 h,平均4.5 h;5例为外伤后指掌侧皮肤软组织坏死择期手术,伤后至手术时间12~26 d,平均18.6 d。 结果术后皮瓣及植皮均成活,创面Ⅰ期愈合。患者均获随访,随访时间6~30个月,平均20个月。手指皮瓣外形满意,色泽正常,质地柔软。末次随访时根据手指总主动活动度(TAM)系统评定,获优20例,良2例,可1例,优良率95.7%。 结论改良邻指双叶皮瓣修复指掌侧大面积皮肤软组织缺损手术操作简便,术后皮瓣外观好,伤指功能恢复满意。

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  • 双叶穿支皮瓣修复指背软组织缺损

    目的总结指背双叶穿支皮瓣修复指背软组织缺损的临床疗效。 方法2015年3月-2016年3月,采用指背双叶穿支皮瓣修复指背软组织缺损13例。男6例,女7例;年龄19~66岁,平均31.7岁。致伤原因:机器冲压伤9例,重物压伤4例。受伤至入院时间40 min~36 h,平均7.4 h。指别:示指3指,中指5指,环指5指。缺损范围1.0 cm×1.0 cm~2.5 cm×2.0 cm。第1皮瓣覆盖缺损创面,第2皮瓣覆盖第1皮瓣供区,第2皮瓣供区直接缝合。 结果术后创面均Ⅰ期愈合。皮瓣均顺利成活,无血管危象发生。12例患者获随访,随访时间3~9个月,平均5.5个月。各皮瓣色泽红润、质地良好;第l皮瓣供区无凹陷、破溃,第2皮瓣供区线性瘢痕愈合,整体外观良好。末次随访时按手指主动活动度(TAM)法评定手功能:优9指、良3指。 结论采用指背双叶穿支皮瓣修复指背创面缺损,手术操作简便,疗效较好。

    Release date:2016-10-21 06:36 Export PDF Favorites Scan
  • EFFECTIVENESS OF MODIFIED Zitelli BILOBED FLAPS FOR REPAIRING SOFT TISSUE DEFECT OF LOWER ONE-THIRD NOSE

    ObjectiveTo investigate the clinical application of the modified Zitelli bilobed flaps in repairing soft tissue defect of lower one-third nose. MethodsBetween February 2009 and February 2014, 26 patients with soft tissue defect of lower one-third nose after resection of basal cell carcinoma underwent reconstruction using modified Zitelli bilobed flaps. There were 15 males and 11 females, aged 48-65 years (mean, 56 years). Tumor involved the skin layer in all patients. According to TNM staging, 19 cases were rated as TisN0M0 and 7 cases as T1N0M0. The disease duration was 1-5 years (mean, 3 years). The mass size ranged from 1.0 cm×0.5 cm to 1.5 cm×1.0 cm. The defect size ranged from 1.5 cm×1.0 cm to 2.0 cm×1.5 cm after resection of basal cell carcinoma. The modified ipsilateral Zitelli bilobde flaps were designed and harvested for one-stage repair of defect, and the double-leaf flap size ranged from 2.5 cm×2.0 cm to 3.0 cm×2.5 cm and 1.5 cm×1.0 cm to 2.0 cm×1.5 cm. The donor site defects were sultured directly. ResultsTwenty-six flaps survived and incision healed primarily. No postoperative complications of hematoma, infection, and necrosis of skin flap occurred. No stretching deformation of local organs, the shape of the nose and face was symmetric. Twenty-six patients were followed up 3-24 months (mean, 13 months). Nasal and facial appearance was good and had no obvious scar formation, and patients were satisfied with the appearance. There was no tumor recurrence during follow-up. ConclusionThe modified Zitelli bilobed flap to repair soft tissue defect of lower one-third nose (the defect diameter within 2.0 cm) can obtain satisfactory effectiveness in appearance.

    Release date:2016-11-14 11:23 Export PDF Favorites Scan
  • 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
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