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find Author "刘刚义" 2 results
  • 多块掌背动脉岛状皮瓣修复多指皮肤软组织缺损

    目的 总结多块掌背动脉岛状皮瓣修复多指皮肤软组织缺损的疗效。 方法2009年7月-2011年8月,采用多块掌背动脉岛状皮瓣修复多指皮肤软组织缺损16例。男11例,女5例;年龄17~69岁,平均38岁。掌侧缺损4例,背侧缺损12例。软组织缺损范围1.0 cm × 0.5 cm~5.5 cm × 2.5 cm。伤后至入院时间为30 min~8 h,平均3 h。皮瓣切取范围1.2 cm × 1.0 cm~6.5 cm × 3.0 cm。供区拉拢缝合或植皮修复。 结果术后1例皮瓣远端坏死,1例皮瓣轻度感染,均经换药后成活;其余皮瓣及供区植皮均成活,切口均Ⅰ期愈合。术后16例患者均获随访,随访时间6~24个月,平均12个月。皮瓣外形、质地良好,末次随访时皮瓣两点辨别觉为7~11 mm;手指功能根据中华医学会手外科学会上肢部分功能评定试用标准:获优9例,良6例,可1例,优良率为93.8%。 结论利用掌背动脉、掌心动脉及掌侧指总动脉交通支相吻合的解剖特点,选择其各自走行上的掌背皮瓣修复多指皮肤软组织缺损,具有手术操作简便、安全、可靠等优点。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • REVERSE ISLAND FLAP OF DIGITAL ARTERY PARALLEL FOR REPAIRING DEGLOVED INJURIES OF FINGERTIP

    Objective To investigate the effectiveness of reverse island flaps of digital artery parallel for repairing degloved injuries of the fingerti p. Methods Between June 2008 and January 2010, 13 cases of degloved injuries of the fingertip were treated. There were 8 males and 5 females with an average age of 34 years (range, 19-62 years). The causes of injuries were as follow: impact and press injury in 5 cases, wringer injury in 7 cases, and crush injury in 1 case. The injured fingers were comprised of index finger in 6 cases, middle finger in 4 cases, ring finger in 2 cases, and l ittle finger in 1 case. The size of skin and soft tissue defect ranged from 2.0 cm × 1.8 cm to 3.0 cm × 2.5 cm. Three cases compl icated by fracture of thedistal phalanx, 1 case by rupture of the insertion of extensor tendon, and 1 case by rupture of the insertion of flexor tendon. The average time from injure to surgery was 4 hours (range, 1 hour and 30 minutes-12 hours). Two neighboring skin flaps located in the same course of digital artery were adopted to repair defect of the fingertip. The size of proximal skin flap ranged from 1.2 cm × 1.0 cm to 2.0 cm × 1.5 cm and the size of distal skin flap ranged from 1.1 cm × 1.0 cm to 1.5 cm × 1.3 cm. The free skin grafts were used to repair the donor sites. Results Circulation crisis occurred in 1 case at 2 hours after operation and was el iminated by interval disconnecting. The other flaps and skin grafts survived and the wounds healed by first intention. The patients were followed up 6-18 months (mean, 10 months). All flaps presented the satisfactory appearance and texture, and the flexion and extension function of wounded fingers recovered to normal. Two-point discrimination ranged from 7 to 11 mm at last follow-up. According to the functional assessment criteria of upper l imb formulated by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in 9 cases, good in 3 cases, and fair in 1 case with an excellent and good rate of 92.3%. Conclusion Based on the anatomical features of communicating branches of distal interphalangeal joint, two neighboring flaps located in the same course of digital artery are adopted to repair soft tissue defect of the fingertip. This surgical method is a simple and effective method.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
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