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find Author "张吉平" 3 results
  • DESIGN OF FLAP USING EIGHT-POINT-LOCATION METHOD AND CLINICAL APPLICATION

    Objective?To introduce a new method of flap design and to investigate the feasibility of the clinical application.?Methods?Between April 2006 and November 2009, 89 patients with skin and soft tissue defects were treated. There were 47 males and 42 females with an average age of 36 years (range, 16-67 years). The injuries were caused by machine crush (38 cases), electric saw (16 cases), electricity (8 cases), traffic accident (18 cases), rolling machine (3 cases), and crash of heavy object (6 cases). The locations were forearm in 4 cases, palm in 23 cases, finger in 41 cases, lower leg in 7 cases, and dorsum of foot in 14 cases. All the cases complicated by exposure of tendons or bones. The time from injury to hospitalization was 30 minutes to 5 days (mean, 3 hours). The areas of skin and soft tissue defect ranged from 2.0 cm × 1.5 cm to 26.0 cm × 18.0cm. The wounds were repaired with the pedicle flaps in 72 cases and the free flaps in 17 cases. All the flaps were designed with eight-point-location method. A trapezoid was made in the raw surface and the four vertexes of the trapezoid were on the edge of the raw surface. The exterior points of the heights of arciforms were made on the edge of the raw surface too. The eight points were the labelling points. The top width, the bottom width, the height of the trapezoid, and the heights of the arciforms could be measured. The above numerus were expanded 5%-10%. The expanded numerus were the corresponding numerus of the skin flap. The size of flaps ranged from 2.2 cm × 1.7 cm to 28.5 cm × 19.5cm. The donor sites were closed directly in 17 cases, and repaired with skin grafts in 72 cases.?Results?All the flaps were successfully dissected according to flap design. When the flaps were transplanted to the wounds, tension of the flaps was appropriate. All the flaps and skin grafts survived. The wounds and incisions at donor sites healed by first intention. Eighty-nine patients were followed up 6 to 26 months (mean, 20 months). The texture, appearance, flexibility, and function of the flaps were satisfactory, and no complication occurred. The sensory restoration of the pedicle flaps were graded as S3-S4.?Conclusion?It is an ideal and simple method to design flap using eight-point-location method. The flaps are precise in the figure and area.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • RESEARCH AND APPLICATION OF MULTIPOINT CENTRALIZATION METHOD IN REMOVAL OF SMALL FOREIGN BODY

    ObjectiveTo introduce a new method to remove the small foreign body in the hand or foot, and to discuss its feasibility and effectiveness. MethodsBetween May 2007 and March 2012, 78 patients with small foreign bodies embedded in the soft tissue of the hand or foot were treated with the method. There were 51 males and 27 females, aged from 7 to 69 years with an average of 32.5 years. The hand, wrist, and foot were involved in 48, 6, and 24 cases respectively. Foreign body type included fiberglass (57 cases), thorn (11 cases), iron (5 cases), bamboo thorn (2 cases), fishbone (2 cases), and metal needles (1 case). The time between injury and operation was 30 minutes to 16 days (mean, 2.6 days). The position and range of the foreign body were defined using the multipoint centralization method before removal surgery. The skin was cut according multipoint connection for finding small foreign body under a microscope. ResultsAll foreign bodies were successfully removed. The mean operation time was 6 minutes (range, 3-22 minutes). Healing of incision by first intention was obtained in all cases; no blood circulation disorders or infection occurred. All the patients were followed up 3 months-3 years (mean, 9 months). The distal limb had no feeling or movement disorders. ConclusionRemoval of small foreign body in soft-tissue using multipoint centralization method is safe and effective.

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  • 间指皮瓣修复手指指端皮肤软组织缺损

    目的 总结间指皮瓣修复手指指端皮肤软组织缺损的疗效。 方法 2012 年 2 月—2017 年 7 月,收治 21 例手指指端皮肤软组织缺损患者。男 15 例,女 6 例;年龄 16~48 岁,平均 35.6 岁。致伤原因:机器伤 12 例,重物压砸伤 5 例,绳索绞伤 2 例,电锯伤 2 例。示指 8 例,中指 5 例,环指 6 例,小指 2 例。受伤至入院时间 30 min ~3 d,平均 2.5 h。单纯指腹缺损 7 例,合并末节指骨远端缺损 14 例;皮肤软组织缺损范围 1.4 cm×1.2 cm~2.4 cm×1.4 cm。均存在邻指中节指背皮肤损伤。于间隔手指中节背侧设计皮瓣,皮瓣范围为 1.6 cm×1.3 cm~2.6 cm×1.6 cm。术后 3~4 周皮瓣断蒂。供区游离植皮修复。 结果 手术时间 1.5~2.2 h,平均 1.7 h。术后 1 例出现张力性水疱,余 20 例皮瓣均成活良好。供区皮片均成活。患者术后均获随访,随访时间 6~30 个月,平均 10.5 个月。修复手指指端饱满,色泽正常;皮瓣两点辨别觉为 5~9 mm,平均 7.2 mm。术后按中华医学会手外科学会上肢部分试用标准评定患指功能:优 16 例,良 4 例,可 1 例,优良率为 95.2%。 结论 邻指皮瓣不能应用时,采用间指皮瓣移植修复手指指端皮肤软组织缺损具有切取简便、皮瓣血管解剖恒定、供区损伤小、术后患指外形和功能良好等优点。

    Release date:2018-12-04 03:41 Export PDF Favorites Scan
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