west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "组织瓣" 60 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
  • Experimental Study of Repairing of Esophagus Defect with Lung Tissue Flap and an Inner Chitosan Tube Stent

    ObjectiveTo investigate the feasibility of lung tissue flap repairing esophagus defect with an inner chitosan tube stentin in order to complete repairing and reconsruction of the esophagus defect.MethodsFifteen Japanese white rabbits were randomly divided into two groups, experiment group(n=10): esophagus defect was repaired with lung tissue flap having inner chitosan tube stent; control group(n=5): esophagus defect was repaired with lung tissue flap without inner chitosan tube stent; and then the gross and histological apearance in both groups were observed at 2, 4,8 weeks after operation, barium sulphate X-ray screen were observed at 10 weeks after operation.ResultsSix rabbits survived for over two weeks in experiment group, lung tissue flap healed with esophageal defect, squamous metaplasia were found on the surface of lung tissue flap in experiment group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and no narrow or reversed peristalsis, the peristalsis was good in experiment group.Four rabbits survived for two weeks and the lung tissue flap healed with esophageal defect, fibrous tissue hyperplasy on the surface of the lung tissue flap in control group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and slight narrow or reversed peristalsis, the peristalsis was not good in control group, otherwise.ConclusionIt is a feasible method to repair the esophageal defect with lung tissue flap with the inner chitosan stent.

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • A PRELIMINARY STUDY ON REPAIRING DEFECTS AT MEDIAL MALLEOLUS IN CHILDREN BY VASCULARIZED FIBULAR HEAD COMPOSITE FLAP

    Objective To investigate the operative method and effectiveness of repairing defects at medial malleolus in children with vascularized fibular head composite flap. Methods Between November 2008 and January 2011, 8 children with bone and soft tissue defects at the medial malleolus were treated. There were 5 boys and 3 girls, aged 2-9 years (mean, 4.6 years). Injuries were caused by machine twisting in 2 cases and by wheel twisting in 6 cases. Soft tissue defect area ranged from 3.5 cm × 3.0 cm to 7.0 cm × 4.5 cm; defect was total in all medial malleolus. The disease duration from injury to admission was 2-8 hours (mean, 4.5 hours). Defects were repaired with vascularized fibular head composite flap carrying the skin around the head of the fibula in 5 cases, and with vascularized fibular head composite flap and skin flap above the medial malleolus in 3 cases having too large defect (gt; 5 cm × 4 cm). The donor sites were repaired with direct suture in 2 cases and with skin graft in 6 cases. Results All 8 fibular head composite flaps and 3 skin flaps above the medial malleolus survived completely. Wounds healed by first intention; the skin grafts at donor sites survived in the other cases except 1 case having local necrosis, with healing of incision by first intention. The patients were followed up 10 months to 3 years (mean, 22 months). The color and elasticity of the flaps were good. All the children had equal leg length. Of 8 cases, 6 had no joint valgus; 2 cases had progressive ankle varus after 1 year of operation. The ankle flexion and extension function returned to normal in 5 cases, and was slightly limited in 3 cases; horizontal side, forward and backward movements had no difference compared with normal side. According to American Orthopaedic Foot and Ankle Society (AOFAS) ankle function evaluation criteria, the results were excellent in 5 cases, and good in 3 cases at 10 months after operation. X-ray film showed that the ankle hole gap development of both sides was similar; no premature closure of the epiphysis or bone bridge formation of the medial malleolus was observed in 6 cases, and bone bridge formed in 2 cases after 1 year of operation. Conclusion The satisfactory short-term effectiveness can be obtained in repairing children medial malleolus and soft tissue defects by vascularized fibular head composite flap, and the reconstructed medial malleolus can develop with the growth of children. Long-term effectiveness still need more follow-up study.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • MENTOCERVICAL RECONSTRUCTION AND EFFECTIVENESS EVALUATION IN TREATMENT OF MENTOCERVICAL CICATRICIAL CONTRACTURE DEFORMITY

    Objective To investigate the procedures and effectiveness of platysma scar flap for reconstructing mentocervical appearance in patients with mentocervical cicatricial contracture deformity. Methods Between April 2004 and August 2011, 26 patients with mentocervical cicatricial contracture deformities were admitted. There were 15 males and 11 females, aged 12-31 years (mean, 18 years). The causes included scald injury in 19 cases and flame injury in 7 cases, including 23 cases of deep second degree burn and 3 cases of third degree burn. The time between injury and scar formation was 6-27 months (mean, 10 months). The mentocervical angle was (117.10 ± 14.46)°, and the cervicomental angle was (143.38 ± 15.68)°. The platysma scar flap transfer (8 cm × 7 cm to 10 cm × 8 cm in size) and skin grafting were performed to reconstruct mentocervical appearance. Results The flap and skin graft all survived and the incisions healed by first intention. All the patients were followed up 6 months-3 years (mean, 16 months). The mentocervical and cervicomental angles were significantly reduced to (89.31 ± 6.30)° and (117.83 ± 10.65)° respectively at 2 weeks after operation (P lt; 0.05), showing no significant difference when compared with normal mentocervical angle (90°) and cervicomental angle (120°) (P gt; 0.05). The satisfactory results of the mentocervical appearance and cervical extension function were obtained in 21 patients whose mentocervical and cervicomental angles were restored to normal. Conclusion Platysma scar flap transfer is an effective method to reconstruct mentocervical appearance and reduce mentocervical and cervicomental angles in patients with mentocervical cicatricial contracture deformity.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 带蒂组织瓣在下肢软组织恶性肿瘤治疗中的应用

    【摘 要】 目的 探讨带蒂组织瓣修复下肢软组织恶性肿瘤切除后组织缺损的临床效果。 方法 1997年7月-2008年4月,收治15例下肢软组织恶性肿瘤患者。男11例,女4例;年龄30~55岁,平均41岁。肿瘤部位:前足2例,足跟6例,踝部4例,小腿2例,腘后1例。肿瘤切除后组织缺损范围为5 cm × 4 cm~20 cm × 12 cm,分别采用足底内侧皮瓣或肌皮瓣(5例)、 腓肠神经营养皮瓣(5例)、 外踝上皮瓣(3例)、 小腿内侧皮瓣(1例)、 缝匠肌皮瓣(1例)修复创面,皮瓣切取范围5.0 cm × 4.5 cm~22 cm × 14 cm。供区直接缝合或游离植皮修复。 结果 术后5~6 d 2例皮瓣部分坏死,术后10 d 1例供区植皮部分坏死,经换药后愈合;其余皮瓣及植皮均成活,创面Ⅰ期愈合。患者均获随访,随访时间1~12年,平均5.2年。2例患者因肿瘤转移死亡,3例局部复发;其余患者皮瓣质地、外观良好,肢体功能良好。获随访5年以上11例,5年生存率为73.3%(11/15)。 结论 根据肿瘤部位选择不同的带蒂皮瓣和肌皮瓣修复肿瘤扩大切除后组织缺损能最大限度减少肢体功能损害,保肢率高。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • REPAIR OF TRAUMATIC METACARPOPHALANGEAL JOINT DEFECT BY METATARSOPHALANGEAL JOINT COMPOSITE TISSUE FLAP AUTOGRAFT

    Objective To investigate the surgical method and effectiveness of repairing traumatic metacarpophalangeal joint defect by the composite tissue flap autograft of the second metatarsophalangeal joint. Methods Between June 2005 and December 2009, 6 cases (6 fingers) of traumatic metacarpophalangeal joint defect were treated with the composite tissue flap autograft of second metatarsophalangeal joint (containing extensor tendon, flexor tendon, proper digital nerve, planta or dorsal flap). All patients were males, aged 18-48 years, including 3 cases of mechanical injury, 2 cases of crush injury, and 1 case of penetrating trauma. The 2nd, 3rd, and 4th metacarpophalangeal joints were involved in defects in 2 cases, repectively, and defects ranged from 1.5 cm × 1.5 cm to 3.0 cm × 2.5 cm in size. All patients had skin and soft tissue defects, and defects ranged from 4 cm × 2 cm to 5 cm × 4 cm in size; and 5 cases complicated by extensor tendon defect (2.5-5.0 cm in length), 3 cases by flexor tendon rupture, and 3 cases by common palmar digital nerve injury. The time from injury to admission was 2-6 hours. Results The composite tissue flaps and skin grafts survived in all cases. All incisions healed by first intention. All patients were followed up 1-5 years. The X-ray films showed good healing between the transplanted metatarsophalangeal joint and metacarpals and phalanges at 9-14 weeks postoperatively. The appearance, colour, and texture of the skin flap were satisfactory, and the senses of pain and touch were recovered. The palmar flexion range of transplanted metacarpophalangeal joints was 50-70°, and the dorsal extension range was 5-10° at last follow-up. According to the functional assessment criteria of upper limb formulated by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in 4 cases, good in 1 case, and fair in 1 case, and the excellent and good rate of 83.3%. No dysfunction of the donor foot was observed. Conclusion The metatarsophalangeal joint composite tissue flap can provide bone, nerve, skin, muscles, and tendons, so it is an effective approach to repair the metacarpophalangeal joint defect and to recover the function of the injured joints in one operation.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • 延长血管蒂的逆行掌背动脉复合组织瓣修复手指复合组织缺损

    目的 总结采用延长血管蒂的逆行掌背动脉复合组织瓣修复手指近侧指间关节以远复合组织缺损的方法及疗效。 方法 2001 年2 月- 2008 年2 月,收治外伤所致手指近侧指间关节以远复合组织缺损17 例19 指。男13 例15 指,女4 例4 指;年龄17 ~ 59 岁,平均33 岁。示指7 指,中指8 指,环指4 指。伴肌腱缺损18 指,指骨缺损2 指。皮肤缺损范围为2.2 cm × 0.8 cm ~ 6.0 cm × 2.8 cm。受伤至手术时间为2 ~ 120 h。术中根据指背动脉在手指近节中段及远1/3 处与指掌侧固有动脉背侧分支相交通的解剖特点,设计延长血管蒂(蒂长1.0 ~ 1.5 cm)逆行掌背动脉皮瓣修复缺损,其中携带肌腱15 例17 指,骨瓣2 例2 指。皮瓣切取范围1.8 cm × 1.0 cm ~ 6.5 cm × 3.0 cm。供区直接缝合或全厚皮片游离植皮。 结果 术后4 例复合组织瓣发生静脉危象,对症处理后成活;其余复合组织瓣均顺利成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合,植皮成活。术后患者均获随访,随访时间3 ~ 12 个月,平均5 个月。皮瓣质地佳、外形良好,颜色接近正常皮肤。手部功能按手外科功能评价标准评定:优16 指,良2 指,可1 指,优良率为94.7%。 结论 延长血管蒂的逆行掌背动脉复合组织瓣具有切取简便、损伤小的优点,是修复手指近侧指间关节以远皮肤、肌腱及骨复合组织缺损的一种理想方法。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • 胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损

    目的 总结胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损的方法及疗效。 方 法 2006 年8 月- 2009 年3 月,采用胫后动脉内踝上穿支蒂网状供血复合组织瓣修复跟后复合组织缺损8 例。男6 例,女2 例;年龄5 ~ 69 岁。压砸伤3 例,交通事故伤5 例。左足3 例,右足5 例。皮肤缺损范围7 cm × 6 cm ~ 10 cm × 8 cm,跟腱缺损范围4.0 cm × 3.0 cm ~ 5.0 cm × 3.5 cm,跟骨缺损范围3 cm × 2 cm × 2 cm 和3 cm × 1 cm × 1 cm。受伤至手术时间为3 ~ 5 周。术中切取皮瓣范围为8 cm × 7 cm ~ 11 cm × 8 cm,肌腱瓣5 cm × 4 cm ~ 6 cm × 4 cm,骨瓣约5 cm × 1 cm × 1 cm 和4 cm × 1 cm × 1 cm。供区游离植皮修复。 结果 术后复合组织瓣及植皮均顺利成活,创面Ⅰ期愈合。8 例均获随访,随访时间8 ~ 15 个月,平均10 个月。皮瓣色泽、质地良好,跟后皮肤无破溃,患肢无提踵功能障碍,能自由行走。 结论 胫后动脉穿支蒂网状供血复合组织瓣可一期修复跟后皮肤、跟腱、跟骨复合组织缺损,手术操作简便,血供可靠。

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • 外伤性唇缺损修复一例

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • REPAIR AND RECONSTRUCTION OF TRAUMATIC DEFECT OF MEDIAL MALLEOLUS IN CHILDREN

    Object ive To inves t igate the operat ive method and cl inical ef fect of repai r ing and reconstructing the traumatic defect of medial malleolus in children with complex tissue flap of vascularized fibular head epiphysis. Methods From July 2003 to December 2007, 8 children with defect of medial malleolus due to wheel injury were treated, including 5 boys and 3 girls aged 2-10 years old. The medial malleolus were completely defected (5 cases at left foot and 3 cases at right foot) and combined with the skin defect around the medial malleolus (4.0 cm × 2.0 cm - 9.5 cm × 5.5 cm). The time from injury to hospital admission was 6-8 hours in 2 cases, and 24-168 hours in 6 cases. The complex of vascularized fibularhead epiphysis and tissue flap was adopted to repair the defect. The flap 4.5 cm × 2.5 cm - 10.0 cm × 6.0 cm in size and the fibular head epiphysis 2.5-3.0 cm in length were harvested. The donor site was sutured directly. Results All wounds healed by first intention, all the composite tissue flap survived with good blood circulation, all the epiphysis of medial malleolus healed within 6-9 weeks, and all the donor sites healed well. All the child patients were followed up for 1-5 year. The color and elasticity of the flaps were good, without cicatricial contracture. The patients had no inversion of ankle joint, with satisfying loading and walking function. Six cases had normal flexion and extension of the ankle and 2 cases were l imited sl ightly (dorsiflexion 10-20°, plantarflexion 35°). Talus has no inner move and ankle joint had no eversion. Seven cases were graded as excellent and 1 as good according to the standard of American Orthopaedic Foot amp; Ankle Society. For the medial malleolus, no premature closure of epiphysis occurred, and the center of ossification grew gradually and well developed l ike the contralateral side. The donor knee joint had normal flexion and extension function, without inversion and instabil ity. Conclusion The complex of vascularized fibular head epiphysis and tissue flap can repair the epiphysis and soft tissue defect of medial malleolus in children at one stage, and the reconstructed medial malleolus can develop with the growth of children. It is a satisfactory method of reconstructing the traumatic defect of medial malleolus in children.

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
6 pages Previous 1 2 3 ... 6 Next

Format

Content