Search

RESEARCH PROGRESS OF EFFECT OF DONOR NERVE ON REGENERATION OF RECIPIENT NERVE IN END-TO-SIDE NEURORRHAPHY

Objective To review the researches of donor nerve’s promoting effect on regeneration of reci pient nerve in end-to-side neurorrhaphy at home and abroad. Methods The latest original l iterature concerning donor nerve’s accelerating effect on regeneration of recipient nerve was extensively reviewed. Results Proper nerve cutting may promote nerve regeneration. But how to quantize the cutting volumn was still a challenge. Conclusion It is important to research thedonor nerve in neurorrhaphy, which can provide evidence for cl inical neurorrhaphy so as to achieve good results.

纵形腹壁下动脉穿支皮瓣修复外阴肿瘤术后缺损创面

目的 总结纵形腹壁下动脉穿支（deep inferior epigastric perforator，DIEP）皮瓣移位修复外阴肿瘤根治术后缺损创面的方法及疗效。 方法 2007 年8 月－ 2009 年8 月，收治5 例57 ～ 68 岁女性外阴肿瘤患者。其中外阴鳞状细胞癌4 例，外阴黑色素瘤1 例。病程3 ～ 5 年。患者均行外阴广泛局部扩大切除术加腹股沟及盆腔淋巴结清扫，肿瘤切除后创面缺损范围为12 cm × 7 cm ～ 15 cm × 6 cm。采用大小为14 cm × 8 cm ～ 16 cm × 9 cm 的纵形DIEP 皮瓣移位修复创面。供区直接缝合。 结果 术后1 例皮瓣远端出现部分坏死，经换药后成活；其余4 例均顺利成活。创面Ⅰ期愈合4 例，Ⅱ期愈合1 例。供区切口均Ⅰ期愈合。术后4 例患者获随访，随访时间8 个月～ 2 年。1 例因外阴鳞状细胞癌复发后不能耐受再次手术而死亡；1 例外阴臃肿影响排尿，予皮瓣修整术后排尿恢复正常；余2 例外阴无臃肿，皮瓣色泽与下腹壁皮肤相似，质地柔软，无尿道口狭窄。供区腹壁无并发症发生。 结论 纵形DIEP 皮瓣移位是修复外阴肿瘤术后缺损创面的有效方法之一。

上臂内侧扩张皮瓣修复鼻背瘢痕