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find Keyword "组织缺损" 263 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
  • REPAIRING SKIN AND SOFT TISSUE DEFECT IN PALM OR DORSUM OF HAND AND FOREARM WITH EPIGASTRIC BILOBED FLAP

    ObjectiveTo introduce the surgical method and effectiveness of repairing skin and soft tissue defect in the palm or dorsum of the hand and forearm with epigastric bilobed flap. MethodsBetween October 2010 and December 2013, 4 male patients with skin and soft tissue defect in the palm or dorsum of the hand and forearm were treated, aged from 36 to 62 years. Of them, 3 cases had degloving injury caused by machines and 1 case had necrosis of fingers and skin after surgery of crush injury. The time from injury to hospitalization was from 3 hours to 15 days. Among the 4 cases, the size of palmar defect was 7 cm×4 cm to 16 cm×6 cm, and the size of dorsal defect was 10 cm×7 cm to 20 cm×10 cm. The epigastric bilobed flap was designed based on the axial vessel which was formed by inferior epigastric artery, superior epigastric artery, and intercostals arteries. The size of flap ranged from 12 cm×4 cm to 18 cm×6 cm in the vertical direction, 15 cm×8 cm to 22 cm×11 cm in the oblique direction. The donor site was directly closed. The pedicles were cut at 22 to 24 days after repairing operation. ResultsAll the flaps survived well with the wound healing by first intention. Four patients were followed up 3 months to 1 year and 2 months. The other flaps had good appearance and texture except 1 bulky flap. The flap sensation basically restored to S2-S3. The function of the hands recovered well. ConclusionSkin and soft tissue defect in the palm or dorsum of the hand and forearm can be repaired with the epigastric bilobed flap, because it has such advantages as big dermatomic area and adequate blood supply. Besides, the operation is practical, safe, and simple.

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • REPAIR OF LARGE TIBIAL BONE AND SOFT TISSUE DEFECTS BY SHORTENING-LENGTHENING METHOD

    Objective To investigate the effectiveness of shortening-lengthening method using Ilizarov technique for repairing large tibial bone and soft tissue defects. Methods Between January 2006 and December 2011, 12 patients with large tibial bone and soft tissue defects were treated by shortening-lengthening method using Ilizarov technique. There were 8 males and 4 females with an average age of 39.3 years (range, 18-65 years). The causes were injury in 8 cases and chronic infection in 4 cases. The area of soft tissue defect was 5 cm × 4 cm to 20 cm × 16 cm, and the length of tibial bone defect was 4.5-8.0 cm with an average of 6.2 cm. Results Incision in the lengthening area healed by first intention; healing of wounds by first intention was achieved in 6 cases, delayed healing in 2 cases, and secondary healing in 4 cases, with no common peroneal nerve injury. All patients were followed up 18-54 months with an average of 29 months. In the lengthening area, the bone healing time was 180-365 days (mean, 267 days), and the healing index was 3.8-4.3 days/mm (mean, 4.1 days/mm). In the shortening area, the bone healing time was 195-380 days (mean, 297 days) in the others except 1 case who was repaired with bone grafting. Mild pin-related infection and loosening were observed in all cases, but no infection occurred in the lengthening or shortening area. At last follow-up, weight bearing of the leg was fully recovered in 12 cases. According to Mazur’s criteria, the function of ankle was excellent in 2 cases, good in 6 cases, and fair in 4 cases. Nine patients had equal limb length, and 3 patients had shortened length less than 2 cm. Conclusion Shortening-lengthening method using Ilizarov technique has the advantages of simple surgery, less complications, easy to close the wound, and good effectiveness in repairing of large tibial bone and soft tissue defects.

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • 改良带蒂(足母)展肌肌皮瓣修复足跟部皮肤恶性黑色素瘤术后缺损

    目的 总结采用改良带蒂(足母)展肌肌皮瓣移位修复足跟部皮肤恶性黑色素瘤扩大切除后软组织缺损的疗效。方法 2008年2月-2011年6月,收治5例足跟部皮肤恶性黑色素瘤患者。男2例,女3例;年龄35~69岁,平均49岁。病程2~10年。足跟原发肿瘤范围为3 cm × 2 cm~5 cm × 4 cm,3例伴破溃。4例肿瘤扩大切除后缺损范围为6 cm × 6 cm~8 cm × 6 cm,1例因伴卫星灶缺损达13 cm × 12 cm;采用大小为6 cm × 6 cm~11 cm × 9 cm改良带蒂(足母)展肌肌皮瓣移位修复缺损,不足部分取中厚皮片修复。供区采用腹股沟中厚皮片修复。 结果术后肌皮瓣及供受区植皮均成活,创面Ⅰ期愈合。2例腹股沟切口发生淋巴漏,经换药和清创术后愈合。5例均获随访,随访时间12~24个月。足跟部皮肤无破裂和磨损,外形丰满、弹性良好,肌皮瓣痛、温觉和耐磨性能良好。足踝伸屈功能正常,恢复负重功能,无肿瘤生长。足部切取肌皮瓣处凹陷明显,第1、2、3趾底感觉减退、麻木。 结论改良带蒂(足母)展肌肌皮瓣修复足跟部皮肤恶性黑色素瘤切除后缺损可获得丰满、耐磨和弹性好的外观。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 低旋转点腓肠神经营养血管皮瓣修复前足软组织缺损

    目的 总结采用低旋转点腓肠神经营养血管皮瓣修复前足软组织缺损的疗效。 方法2007年3月-2011年10月,收治前足软组织缺损 13 例。男12例,女1例;年龄 19~45岁,平均30.7岁。左足 9例,右足 4例。致伤原因:交通事故伤3例,重物砸伤5例,穿刺伤5例。其中一期急诊修复2例,二期修复11例。软组织缺损范围9 cm × 8 cm~17 cm × 14 cm。采用大小为10 cm × 9 cm~19 cm × 16 cm的低旋转点腓肠神经营养血管皮瓣修复创面;供区直接拉拢缝合或游离植皮修复。 结果术后1例皮瓣出现局部张力性水疱,2例发生皮瓣肿胀,经对症处理后均成活;其余皮瓣均顺利成活,创面Ⅰ期愈合。供区植皮均顺利成活,切口Ⅰ期愈合。13例均获随访,随访时间8~24个月,平均14个月。皮瓣质地柔软,外形稍臃肿,不影响穿鞋及行走。皮瓣感觉均不同程度恢复,末次随访时皮瓣两点辨别觉为8~13 mm,平均11 mm。 结论低旋转点腓肠神经营养血管皮瓣手术切取简便,成活率高,是修复前足软组织缺损的有效方法之一。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • REPAIR OF FINGER SOFT TISSUE DEFECT WITH ISLAND FLAP BASED ON VASCULAR CHAIN OF CUTANEOUS BRANCH OF DORSAL METACARPAL ARTERY

    Objective To investigate the operative procedure and the clinical results of the island flap based on the vascular chain of the cutaneous branch of dorsal metacarpal artery for repairing finger soft tissue defect. Methods Between January 2008 and March 2012, 28 cases of tissue defect of fingers (32 fingers) were repaired with the island flaps based on the vascular chain of the cutaneous branch of dorsal metacarpal artery. There were 20 males (23 fingers) and 8 females (9 fingers), with an average age of 29.5 years (range, 14-67 years). The injury causes included 14 cases of crush injury, 6 cases of pressing injury, 5 cases of cutting injury, and 3 cases of avulsion injury. The locations included 10 index fingers, 13 long fingers, 6 ring fingers, and 3 little fingers. There were 9 defects of proximal segment, 12 defects of middle segment, and 11 defects of distal segment. The area of defect ranged from 1.0 cm × 0.8 cm to 5.2 cm × 3.5 cm. The disease duration was 1 hour to 15 days. The area of flaps ranged from 1.2 cm × 1.0 cm to 5.5 cm × 3.8 cm. The donors were closed by suture or were repaired with skin graft. Results Tense blister occurred in 3 cases, which was cured after dressing change; the other flaps survived. Wound obtained primary healing. Twenty-five patients (27 fingers) were followed up 6-25 months (mean, 16.8 months). The flaps had soft texture and satisfactory appearance. Two point discrimination was 6-9 mm (mean, 7.7 mm) at 6 months after operation. The total active movement of fingers was 105-230° (mean, 204.6°). The results were excellent in 17 fingers, good in 8 fingers, and fair in 2 fingers with an excellent and good rate of 92.6%. Conclusion The island flap based on the vascular chain of the cutaneous branch of dorsal metacarpal artery has the advantages of the deverting point from the dorsal point to the palm, the extended vessel pedicle, and expanded operation indications, so it is not necessary to cut the dorsal metacarpal artery. It can be used to repair finger tissue defect.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • 游离腓骨皮瓣修复前足复合组织缺损

    目的 总结游离腓骨皮瓣修复前足复合组织缺损的疗效。 方法2000年6月-2011年11月,应用游离腓骨皮瓣修复前足复合组织缺损12例。致伤原因:交通事故伤8例,压砸伤4例。伤后至入院时间6 h~21 d。创面范围8 cm × 6 cm~30 cm × 18 cm。均伴跖骨缺损,缺损长度5~14 cm。切取腓骨皮瓣范围10 cm × 8 cm~16 cm × 12 cm,腓骨长度6~16 cm。 结果术后1例发生静脉危象,其余皮瓣全部成活。12例均获随访,随访时间1~3年,平均2年5个月。移植骨愈合时间4~6个月。末次随访时采用美国足踝外科协会(AOFAS)评分,为70~92分,平均81分。 结论游离腓骨皮瓣可一期修复前足复合组织缺损,是较理想的治疗方法。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • 小腿远端皮支链血管皮瓣修复足踝部缺损的疗效观察

    目的 总结小腿远端皮支链血管皮瓣修复足踝部软组织缺损的疗效。 方法2008年5月-2011年10月,收治11例足踝部软组织缺损患者。男9例,女2例;年龄20~70岁,平均46.5岁。其中外伤致软组织缺损8例,伤后至手术时间2 h~21 d;恶性肿瘤切除后缺损3例。缺损范围为4 cm × 4 cm~7 cm × 7 cm;创面伴骨、肌腱外露。采用大小为4.5 cm × 4.5 cm~9.0 cm × 9.0 cm的小腿皮支链血管皮瓣修复缺损。供区直接拉拢缝合或游离植皮修复。 结果1例皮瓣术后发生远端皮缘坏死,经换药后二期修整缝合愈合;其余皮瓣均顺利成活,创面均Ⅰ期愈合。供区植皮均成活;切口Ⅰ期愈合10例,Ⅱ期愈合1例。术后患者均获随访,随访时间6~12个月,平均8个月。皮瓣外形不臃肿,色泽、质地优良,耐磨无破溃,穿鞋行走自如。 结论小腿远端皮支链血管皮瓣不牺牲主要血管及皮神经,手术操作简便,术后成活率高,外观较好,是修复足踝部软组织缺损的理想方法之一。

    Release date:2016-08-31 04:06 Export PDF Favorites Scan
  • TISSUE TRANSPLANTATION WITH BONE TRANSMISSION FOR TREATING LARGE DEFECTS OF TIBIAL BONE AND SOFT TISSUE

    Objective To investigate the effectiveness of tissue transplantation combined with bone transmission in treatment of large defects of tibial bone and soft tissue. Methods Between February 2006 and February 2011, 15 cases of traumatic tibia bone and soft tissue defects were treated. There were 12 males and 3 females, aged from 16 to 54 years (mean, 32 years). After internal and external fixations of fracture, 11 patients with open fracture (Gustilo type III) had skin necrosis, bone exposure, and infection; after open reduction and internal fixation, 2 patients with closed fracture had skin necrosis and infection; and after limb replantation, 2 patients had skin necrosis and bone exposure. The area of soft tissue defect ranged from 5 cm × 5 cm to 22 cm × 17 cm. Eight cases had limb shortening with an average of 3.5 cm (range, 2-5 cm) and angular deformity. The lenghth of bone defect ranged from 4 to 18 cm (mean, 8 cm). The flap transplantation and skin graft were used in 9 and 6 cases, respectively; bone transmission and limb lengthening orthomorphia were performed in all cases at 3 months after wound healing; of them, 2 cases received double osteotomy bone transmission, and 14 cases received autologous bone graft and reset after apposition of fracture ends. Results All flaps and skin grafts survived; the wound healed at 3.5 months on average (range, 3 weeks-18 months). The length of bone lengthening was 6-22 cm (mean, 8 cm). The time of bone healing and removal of external fixation was 9.5-39.0 months (mean, 15 months). The healing index was 40-65 days/cm (mean, 55 days/cm). All patients were followed up 1-5 years (mean, 4 years). The wounds of all the cases healed well without infection or ulceration. The functions of weight-bearing and walking were recovered; 6 cases had normal gait and 9 cases had claudication. The knee range of motion was 0° in extention, 120-160° in flexion (mean, 150°). According to the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system for ankle function, the results were excellent in 7 cases, good in 4 cases, and fair in 4 cases, with an excellent and good rate of 73.3%. Conclusion Tissue transplantation combined with bone transmission is an effective method to treat large defects of soft tissue and tibial bone, which can increase strength of bone connection and reduce damage to the donor site.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • REPAIRING HALLUX METATARSOPHALANGEAL SKIN AND SOFT TISSUE DEFECTS WITH MEDIAL FLAP WITH DOUBLE BLOOD SUPPLY SYSTEM IN ELDERLY PATIENTS

    Objective To investigate the effectiveness of repairing hallux metatarsophalangeal skin and soft tissue defect with medial flap with double blood supply system in elderly patients. Methods Between June 2011 and March 2012, 9 cases (9 toes) of skin and soft tissue defect at hallux metatarsophalangeal joint were treated with medial flap with double blood supply system. There were 7 males and 2 females, aged 60-70 years (mean, 65.4 years). Injury included crush injury in 5 cases, traffic accident injury in 4 cases. The interval of injury and operation ranged from 3 hours to 5 days (mean, 35 hours). The patients had bone or tendon exposure with pollution of wounds. The size of defects ranged from 2.0 cm × 1.5 cm to 2.5 cm × 2.0 cm. The size of flaps ranged from 2.0 cm × 1.7 cm to 3.0 cm × 2.2 cm. Medial dorsal nerves were anastomosed with toe nerves to recover flap sensation. The donor site was repaired with skin grafting. Results All 9 flaps and skin grafting survived completely, and primary healing of wounds were obtained. Nine patients were followed up 6-8 months (mean, 7 months). The colour, texture, and contour of the flaps were good. The two-point discrimination of the flaps was 12-16 mm (mean, 14 mm) at last follow-up. The patients could walk normally. No scar contracture formed at donor site. No wear occurred. Conclusion The medial flap with double blood supply system can be used to repair hallux metatarsophalangeal skin and soft tissue defect in elderly patients because the flap can be easily obtained, has good blood supply, and has no injury to the main artery and nerve.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
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