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find Keyword "交腿皮瓣" 3 results
  • 逆行隐神经皮瓣交腿移位修复难治足踝部创面

    目的 总结采用逆行隐神经皮瓣交腿移位修复难治足踝部创面的方法及疗效。 方法 2005 年9 月-2010 年11 月,采用逆行隐神经皮瓣交腿移位修复9 例难治足踝部创面。男8 例,女1 例;年龄17 ~ 47 岁,平均34.5 岁。交通事故伤5 例,重物压砸伤3 例;伤后至入院时间为2 h ~ 6 个月。脉管炎1 例,病程18 个月。缺损部位:踝部4 例,足跟部3 例,前足2 例。缺损范围为6 cm × 5 cm ~ 17 cm × 11 cm。术中皮瓣切取范围为8 cm × 6 cm ~ 16 cm × 10 cm,术后3 ~ 5 周行皮瓣断蒂。供区游离植皮修复。 结果 1 例感染创面术后4 d 发生局限感染,经换药处理后愈合,皮瓣成活;其余交腿皮瓣及供区植皮均顺利成活,创面Ⅰ期愈合。患者均获随访,随访时间6 ~ 34 个月,平均16 个月。皮瓣质地优良,无溃疡发生。术后22 个月皮瓣两点辨别觉为8 ~ 10 mm,均恢复保护性感觉。足踝均能负重行走,踝关节活动范围:背伸8 ~ 20°,跖屈10 ~ 35°。供区术后足背内侧感觉支配区麻木感范围随时间延长缩小。 结论 逆行隐神经皮瓣切取简便,厚薄适度,不损伤知名血管,术后可恢复皮瓣感觉,有效防止皮瓣再破溃,是修复足踝部创面的较好方法之 一。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • CLINICAL STUDIES ON MAINTENANCE OF CROSS-LEG POSITION THROUGH INTERNAL FIXATION WITH KIRSCHNER WIRE AFTER CROSSLEG FLAP PROCEDURE

    Objective To study the feasibility of a new method for the cross-leg position maintained by the Kirschner wire internal fixation after the cross-leg flap procedure. Methods From December 2004 to October 2005, 5 patients (4 males, 1 female; aged 14-52 years) were admitted to our department, who suffered from the tibia exposure or the internal fixation plate exposure after operation because of the tibia fracture by trauma for 1-8 weeks. The soft tissue defects ranged in area from 2.4 cm × 2.0 cm to 4.2 cm × 3.0 cm. The soft tissue around the wound in the leg was too poor in condition to perform an operation of the local flap transplantation, but the wound and the tibia had no obvious infection, so an operation of the cross-leg flap transplantation was performed to cover the wounds. The operation was performed with the routine crossleg flap method introduced in the medical literature. After operation the cross-leg position was maintained through a simple internal fixation with two Kirschner wire, which were inserted through the tibia of the cross region of both thelegs, and layers of dressings were placed as a cushion between the crossed legsin case of the crushing skin ulcer formation. The effect of fixation, blood circulation in the cutaneous flap, and the stress of the pedicle were observed postoperatively. After 3-4 weeks the pedicle of the cross-leg flap was cut off; the crossed legs were detached and the Kirschner wire were pulled out. Results All the flaps survived with a good blood circulation and a low pedicle stress. The patients had a relatively comfortable position because all the areas of the legs could be allowed to make some motions except the cross-area ofthe legs. Another advantage of this fixation method was its convenience for observing the blood circulation of the cutaneous flap and for changing the dressings. Neither infection in the holes of the Kirschner wire nor crushing skin ulcer formation in the area of the cross-leg could be observed. The follow-up for 3-18 months revealed that all the flaps were in good condition with no edema, contracture or skin pigmentation. Conclusion The method of usingthe Kirschner wire to maintain the cross-leg position after the crossleg flapprocedure has more advantages than the plaster fixation. This improved method is simpler, and can achieve a tighter fixation in the crossleg area to maintainthe cross-leg position, allowing a micro-motion in other parts of the legs. The patients can have a relatively comfortable posture, and have a more convenient dressing changes and observation on the blood circulation in the flaps.

    Release date:2016-09-01 09:25 Export PDF Favorites Scan
  • Clinical application of changeable cross-leg style sural neurovascular flap in repairing contralateral fairly large soft tissue defect on dorsum of forefoot

    Objective To explore the effectiveness of changeable cross-leg style sural neurovascular flap in repairing contralateral fairly large soft tissue defects on dorsum of forefoot. Methods Between June 2006 and June 2015, 12 patients with fairly large soft tissue defect on dorsum of forefoot were treated. There were 8 males and 4 females, with an average age of 35.6 years (range, 18-57 years). Defects were caused by traffic accident injury in 4 cases, machine crush injury in 3 cases, and heavy object crush injury in 3 cases, with a median disease duration of 11 days (range, 5 hours to 28 days) in the 10 cases; the defect cause was atrophic scar in 2 cases, with disease duration of 2 years and 3 years respectively. The wound size of soft tissue ranged from 6.2 cm×4.1 cm to 11.5 cm×7.4 cm; combined injuries included tendon exposure in all cases and bone exposure in 6 cases. The changeable cross-leg style sural neurovascular flaps were used to repair defects. The width and length of flap pedicle were increased. The cross-leg position was maintained with the elastic net bandage. The size of flaps was 16 cm×7 cm to 21 cm×11 cm, with a pedicle of 8-16 cm in length and 5-6 cm in width. Results After operation, 10 flaps survived, and wound healed by first intention. Extravasated blood occurred at the flap edge in 2 cases and was cured after symptomatic treatment. No pressure sore occurred. All patients were followed up 3-24 months (mean, 7 months). The appearance and function of the affected legs were good, and the flaps had soft texture and normal color. Conclusion Changeable cross-leg style sural neurovascular flap can achieve good effectiveness in repairing fairly large soft tissue defect on dorsum of forefoot. Some drawbacks of single cross-leg style can be avoided.

    Release date:2017-03-13 01:37 Export PDF Favorites Scan
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