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find Keyword "串联皮瓣" 3 results
  • RECONSTRUCTION OF SEVERE CONTRACTURE OF THE FIRST WEB SPACE AND WRIST BY INCORPORATING PEDICLED RETROGRADE FLAP OF FOREARM TRANSPLANTATION

    Objective To summarize the therapeutic effectinevess of incorporating pedicled retrograde flap of forearm transplantation for reconstructing severe contracture of the first web space and wrist. Methods Between November 2005 and February 2010, 26 patients with severe contracture of the first web and wrist were treated. There were 18 males and 8 females with an average age of 27 years (range, 12-45 years). The locations were the right sides in 15 cases and the left sides in 11cases. The injury reason included hot water scald in 7 cases, explosion hurt in 5 cases, traffic accident in 3 cases, hot pressing in 5 cases, and flame burns in 6 cases. The duration of scar contracture ranged from 6 to 26 months with an average of 11 months. According to the evaluation standard by GU Yudong et al., all had severe contracture of the first web space, and concomitant injuries included adduction deformity thumb, l imitation of the thumb extension and opposition function, and carpometacarpal flexion joint deformity. After scar contracture was released, the defect size ranged from 5.8 cm × 4.5 cm to 11.3 cm × 7.2 cm, which were repaired by the incorporating pedicled retrograde flap of forearm of 6.5 cm × 5.0 cm to 12.5 cm × 8.0 cm at size. The donor sites were directly sutured or repaired with skin graft. Results Bl ister and partial necrosis occurred at the distal end of the flaps in 2 cases, which were cured after dressing change. The other flaps survived and wounds healed by first intention. Incisions at donor sites healed by first intention. Twenty-six patients were followed up 6 to 24 months (mean, 15 months). The patients had functional recovery in thumb adduction and opposition at different degrees. At 6 months after operation, according to the Swanson et al. AMA system for total thumb activity, the total thumb function was improved significantly, and according to Jensen et al. measurement, the width and angle of the first web space were significantly increased, all showing significant differences (P lt; 0.05). Conclusion Incorporating pedicled retrograde flap of forearm transplantation for repairing severe contracture of the first web space and wrist could augment the first web space and improve the wrist flexible function.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • 第一跖背动脉皮瓣串联足母趾腓侧皮瓣移植修复手部贯通伤

    目的总结采用第1跖背动脉皮瓣串联趾腓侧皮瓣游离移植修复手部贯通伤的疗效。方法2007年1月-2011年12月,采用第1跖背动脉皮瓣串联趾腓侧皮瓣游离移植修复手部贯通伤12例。男8例,女4例;年龄18~52岁,平均35岁。致伤原因:冲床伤9例,火器伤3例。受伤至入院时间3~12 h,平均6 h。患者手掌皮肤缺损范围为2.0 cm×1.5 cm~3.0 cm×3.0 cm,手背缺损范围为3.5 cm×3.0 cm~5.0 cm×4.0 cm。其中合并掌骨缺损或骨折7例,伸肌腱损伤7例,指动脉损伤3例,指总神经损伤6例。供区中厚皮片游离植皮修复。结果术后所有皮瓣及植皮均成活,创面Ⅰ期愈合。12例均获随访,随访时间6~18个月,平均10个月。皮瓣外观满意,末次随访时皮瓣两点辨别觉为0.6~1.0 cm,平均0.8 cm。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:获优10例,良2例。结论第1跖背动脉皮瓣串联趾腓侧皮瓣与手部皮肤外观、质地相近,吻合血管易于成活,是修复手部贯通伤的理想皮瓣。

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  • COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER

    ObjectiveTo compare the effectiveness of complex defects repair between using chimeric anterolateral thigh flap and series-wound flaps after resection of oral and maxillofacial cancer. MethodAfter resection of oral and maxillofacial cancer, defect was repaired with chimeric anterolateral thigh flap in 39 patients between January 2011 and July 2014 (chimeric anterolateral thigh flap group); and defect was repaired with series-wound flaps in 35 patients between January 2009 and December 2010 (series-wound flaps group). There was no significant difference in gender, age, duration of disease, tumor type, tumor staging, defect location, and defect area between 2 groups (P>0.05) . The operation time, flap harvesting and microvascular anastomosis time, stomach tube extraction time, and oral feeding time were recorded and compared between 2 groups, and postoperative complications were observed; the effectiveness was evaluated according to clinical efficacy evaluation table of bone and soft tissue defects reconstruction surgery in oral and maxillofacial region. ResultsVascular crisis occurred in 2 cases of chimeric anterolateral thigh flap group, and 4 cases of series-wound flaps group. Partial necrosis appeared at distal end of a series-wound flaps, and oral fistula and infection developed in 3 series-wound flaps. The other flaps and the grafted skin at donor site survived; wounds at recipient site healed by first intention. The operation time, stomach tube extraction time, and oral feeding time of chimeric anterolateral thigh flap group were significantly shorter than those of series-wound flaps group (P<0.05) , while the flap harvesting and microvascular anastomosis time was significantly longer than that of series-wound flaps group (P<0.05) . The patients were followed up 1-5 years (mean, 2.5 years). At 3 months after operation, the appearance, patients' satisfaction, working conditions, oral closure function, chew, language performance, and swallowing scores of the chimeric anterolateral thigh flap group were significantly better than those of the series-wound flaps group (P<0.05) , while there was no significant difference in diet, mouth opening degree, oral cavity holding water test, and occlusion scores between the 2 groups (P>0.05) . ConclusionsUsing chimeric anterolateral thigh flap for defect repair after resection of oral and maxillofacial cancer can significantly shorten the operation time, accelerate postoperative rehabilitation, and help the functional recovery of oral closure, chewing, language performance, swallowing function when compared with the series-wound flaps.

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