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find Author "李振武" 3 results
  • 带远端腓肠神经血管束腓肠肌肌皮瓣推进修复跟部皮肤及跟腱缺损

    目的 总结带远端腓肠神经血管束腓肠肌肌皮瓣推进修复跟部皮肤合并跟腱缺损的临床疗效。 方 法 2000 年3 月- 2008 年12 月,收治跟部皮肤合并跟腱缺损16 例。男10 例,女6 例;年龄5 ~ 48 岁,中位年龄23 岁。致伤原因:挤压伤8 例,重物砸伤3 例,交通事故伤5 例。皮肤缺损范围为5 cm × 3 cm ~ 8 cm × 4 cm,跟腱缺损长度4 ~ 8 cm。其中急诊手术11 例,伤后至手术时间2.5 ~ 7.0 h;择期手术5 例,伤后至手术时间7 ~ 20 d。术中采用保留远端蒂腓肠神经血管束腓肠肌肌皮瓣一次性推进修复跟部皮肤及跟腱缺损,肌皮瓣切取范围15 cm ×8 cm ~ 30 cm × 15 cm。供区创面均直接拉拢缝合。 结果 术后肌皮瓣均顺利成活,跟腱及供受区切口均Ⅰ期愈合。16 例均获随访,随访时间6 ~ 18 个月,平均12 个月。末次随访时,根据尹庆水等的疗效评价标准:获优10 例,良6 例,优良率100%。跟部两点辨别觉为5 ~ 7 mm,足外侧缘两点辨别觉为6 ~ 8 mm。 结论 保留远端腓肠神经血管束腓肠肌肌皮瓣可一次性推进修复足跟部皮肤及跟腱缺损,术后肌皮瓣远端血运丰富,抗感染能力强,足跟部有良好的皮肤感觉,耐磨,外观不臃 肿。

    Release date:2016-09-01 09:03 Export PDF Favorites Scan
  • REPAIR OF SOFT TISSUE DEFECT IN FINGER WITH MODIFIED REVERSE DORSAL DIGITAL FASCIA FLAP

    To investigate the operative method of repairing soft tissue defect of finger with modified reverse dorsal digital fascia flap and its cl inical effect of preventing and treating venous crisis. Methods From February 2005 to March 2007, 19 cases (22 fingers) with soft tissue defect of finger were treated, including 14 males (17 fingers) and 5 females (5 fingers) aged 2-62 years old (median 26 years old). There were 8 cases of cutting injury, 6 cases of crush injury, 4 cases of avulsion injury, and 1 case of hot crush injury, involving 3 thumbs, 7 index fingers, 6 middle fingers, 4 ring fingers and 2 l ittle fingers. The size of soft tissue defect was 1.5 cm × 0.8 cm-5.5 cm × 1.5 cm, and the time from injury to operation was 2-11 hours(average 7 hours). The axis of flaps was the l ine of transverse striation of fingers via dominant artery. The flaps were deflected dorsally, as “b” or “d”, to cover the wounds. Reverse dorsal digital fascia flaps 1.8 cm × 1.0 cm-6.0 cm × 2.0 cm in size were adopted to repair the defects. The donor site underwent skin grafting fixation. Results All flaps survived, without venous crisis and obvious swollen. The grafted skin in the donor site all survived. All patients were followed for 6-18 months (average 11 months). Postoperatively, color and texture of the grafted flaps were similar to that of normal skin, and the pulp of the fingers was normal. The two-point discrimination was 8-11 mm, and the activities of interphalangeal joint of all injured fingers were normal. Conclusion The modified reverse dorsal digital fascia flap is ideal for repairing soft tissues defects of the fingers, and can decrease the occurrence of venous crisis.

    Release date:2016-09-01 09:07 Export PDF Favorites Scan
  • 延长血管蒂指背动脉皮瓣修复手部软组织缺损

    目的 总结延长血管蒂指背动脉皮瓣一期修复手部软组织缺损的疗效。 方法 2002 年3 月- 2006年8 月,采用延长血管蒂的指背动脉皮瓣修复16 例手指、手掌部皮肤软组织缺损。男11 例,女5 例;年龄15 ~ 55 岁。电锯伤8 例,轧面机挤压伤3 例,梳棉机撕脱伤2 例,创伤后瘢痕挛缩畸形3 例。缺损范围3.0 cm × 2.0 cm~ 7.5 cm × 1.8 cm。13 例伤后至手术时间为3 ~ 8 h,3 例为择期手术。术中切取皮瓣范围3.5 cm × 2.5 cm ~ 8.0 cm × 2.0 cm。供区创面取中厚皮片游离移植。 结果 16 例术后皮瓣均成活,切口均Ⅰ期愈合。供区植皮均成活。患者均获随访,随访时间3 ~ 12 个月。皮瓣两点辨别觉6.0 ~ 8.2 mm,平均7.1 mm。皮瓣外形满意,质地良好,关节活动正常。 结论 延长血管蒂指背动脉皮瓣切取简便,成活率高,既可单独应用修复较小创面缺损,也可与邻指背侧动脉皮瓣联合应用,切取双叶皮瓣,修复较大创面缺损,为临床修复手掌、手指部缺损提供了一种可供选择的方法。

    Release date:2016-09-01 09:16 Export PDF Favorites Scan
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