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find Keyword "游离移植" 44 results
  • ANATOMY STUDY ON MICRO TRANSVERSE FLAP PEDICLED WITH SUPERFICAL PALMAR BRANCH OF RADIAL ARTERY FROM PALMAR WRIST

    Objective To study the anatomical basis of micro transverse flap pedicled with the superfical palmar branch of radial artery from the palmar wrist for using this free flap to repair soft tissue defect of the finger. Methods Thirty-eight fresh upper limb specimens (22 males and 16 females; aged 26-72 years with an average of 36 years; at left and right sides in 19 limbs respectively) were dissected and observed under operating microscope. Two specimens were made into casting mould of artery with bones, and 2 specimens were injected with red emulsion in radial artery. Thirty-four specimens were injected with 1% gentian violet solution in the superfical palmar branch of the radial artery. A transverse oval flap in the palmar wrist was designed, the axis of the flap was the distal palmar crease. The origin, distribution, and anastomosis of the superfical palmar branch of the radial artery were observed. Results The superficial palmar branch of the radial artery was constantly existed, it usually arises from the main trunk of the radial artery, 1.09-3.60 cm to proximal styloid process of radius. There were about 2-5 branches between the origin and the tubercle of scaphoid bone. The origin diameter was 1.00-3.00 mm, and the distal diameter at the styloid process of radius was 1.00-2.90 mm. The venous return of flap passed through 2 routes, and the innervations of the flap mainly from the palmar cutaneous branch of the median nerve. The area of the flap was 4 cm × 2 cm-6 cm × 2 cm. Conclusion The origin and courses of the superficial palmar branch of the radial artery is constant, and its diameter is similar to that of the digital artery. A transverse oval flap pedicled with the superfical palmar branch of radial artery in the palmar wrist can be designed to repair defects of the finger.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • MECHANISM OF IMPROVED REVASCULARIZATION OF FREE FAT GRAFTING WITH ADIPOSE-DERIVED STEM CELLS

    Objective To review the mechanism of improved revascularization of free fat grafting with adipose-derived stem cells (ADSCs). Methods The literature related to the basic researches of ADSCs in free fat grafting and angiogenesis was reviewed. Results Angiogenesis is a sequence process in time and space which is regulated by various factors. ADSCs possess the capability of secreting many angiogenic growth factors and differentiating into various lineages.Conclusion ADSCs affect every process of angiogenesis with clear improved angiogenic effects, however, the mechanisms of angiogenic effects need the further researches.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • 第2 趾间关节游离移植治疗手指部复合伤

    目的 介绍一种带血管和皮肤的足近节趾间骨关节皮瓣修复外伤性指骨缺损合并指关节损伤的方法。 方法 2004 年11 月- 2007 年10 月,采用游离带足中趾中节趾间骨关节皮瓣修复手指部复合伤6 例,男5 例,女1 例;年龄21 ~ 53 岁。手指掌侧皮肤损伤4 例,手指背侧皮肤损伤2 例;其中2 例合并化脓性感染。骨关节缺损范围1.1 cm × 0.4 cm ~ 2.5 cm × 1.0 cm,皮瓣缺损范围1.8 cm × 0.8 cm ~ 2.8 cm × 1.3 cm。术前近节指间关节活动度伸0 ~ 10°,屈10 ~ 20°。根据中华医学会手外科学会上肢断肢再植功能评定试用标准,得分0 ~ 1 分,关节活动度为差。伤后至手术时间1 h ~ 6 d,平均3 d。 结果 6 例骨关节皮瓣术后全部成活,无感染,住院时间7 ~ 26 d。X 线片示4 例术后6 周有骨痂出现,2 例合并局部化脓性感染者于术后2 个月有骨痂出现。全部获7 ~ 20 个月随访,皮瓣血运、弹性、质地良好,外形较满意。两点辨别觉为4 ~ 7 mm。关节活动度:伸0 ~ 10°,屈40 ~ 60°。术后评定得分1.5 ~ 2.5 分。 结论 带皮肤的第2 足中趾近节趾骨关节皮瓣游离移植修复外伤性指关节缺损,切取方便、手术效果良好,对供区无功能影响。

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • RECONSTRUCTION OF METACARPOPHALANGEAL JOINT DEFECT BY THE SECOND TOE PROXIMAL INTERPHALANGEAL JOINT WITH SKIN FLAPS

    Objective To invest igate the operat ive method and cl inical ef f icacy of reconstruct ing metacarpophalangeal joint defect by the second toe proximal interphalangeal joint with skin flaps. Methods From March 2003 to January 2008, 26 cases (26 fingers) with metacarpophalangeal joint defect were treated, including 19 males and 7 females aged 18-36 years old (average 27 years old). Among them, 23 cases were caused by mechanical injury and the time from injury to operation was 1-6 hours; while 3 cases suffered from secondary injury due to trauma and the time from injury to operation was 3-12 months. Four thumbs, 10 index fingers, 8 middle fingers, 3 ring fingers and 1 l ittle finger were injured.The metacarpophalangeal joint defects were 2 cm × 1 cm-4 cm × 2 cm in size, and 22 cases were combined with skin and soft tissue defect (1.5 cm × 1.5 cm - 6.0 cm × 5.0 cm). During operation, the second toe proximal interphalangeal joint with skin flaps was transplanted to reconstruct those defects, 20 fingers received whole-joint transplantation and 6 fingers received halfjoint transplantation. The skin flaps ranging from 2.0 cm × 1.5 cm to 6.5 cm × 6.0 cm in size were adopted. The donor site of 21 cases received toe amputation, and the rest 5 cases received joint fusion. Results The transplanted joints and skin flaps of all the 26 fingers survived. All incisions and donor sites healed by first intention. All patients were followed up for 6-20 months (average 12 months). The union of transplanted joints was achieved in all the cases at 6-12 weeks after operation, no bone nonunion and refracture occurred. The flexion range of transplanted metacarpophalangeal joints was 30-75° (average 45°). Joint activity was evaluated according to the total active movement/total passive movement assessment criteria, 8 fingers were excellent, 13 good, 3 fair, 2 poor, and the excellent and good rate was 80.77%. The foot donor-site abil ity to walk was unaffected. Conclusion Applying second toe proximal interphalangeal joint with skin flaps is an effective approach to reconstruct the metacarpophalangeal joint defect, and the function recovery of the injured joints is satisfying.

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • 游离足足母趾断层甲床移植修复手指甲床缺损

    目的 总结足趾断层甲床移植修复手指甲床缺损的方法及临床疗效。 方法 2003 年1 月-2007 年12 月,采用足足母趾断层甲床游离移植修复17 例甲床缺损。男9 例,女8 例;年龄17 ~ 54 岁,平均31 岁。均为机器损伤。拇指5 例,示指4 例,中指4 例,环指3 例,小指1 例。甲床缺损范围7 mm × 6 mm ~ 12 mm × 10 mm。6 例为单纯甲床缺损,5 例伴皮肤缺损,3 例伴末节指骨骨折,3 例伴背侧骨皮质缺损。患者甲基质均完整。伤后至入院时间2.0 ~ 6.5 h。 结 果 1 例术后5 d 出现创缘渗液,经换药后瘢痕愈合;1 例术后10 d 出现点状液化,经换药后成活。余患者移植甲床血运良好,创面Ⅰ期愈合。足足母趾供区2 例出现甲下积血,经换药后Ⅰ期愈合,余供区均Ⅰ期愈合。患者均获随访,随访时间6 ~ 27 个月,平均18 个月。根据吕桂欣等评价标准进行疗效评定,优11 例,良4 例,差2 例,优良率达88.24%。供区足足母趾甲生长良好。 结 论 甲基完整的单个手指甲床缺损采用足足母趾断层甲床移植修复不仅可以保留指体完整性,且能恢复指甲外观和功能,对足部供区无明显影响。

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • MAFbx EXPRESSION AFTER FREE MUSCLE TRANSPLANTATION AND ITS RELATIONSHIP WITH MUSCLE FUNCTION

    Objective To study the quantitative changes of ubiquitin l igase MAFbx mRNA and protein expression, muscle atrophy and muscle function following free muscle transplantation and to explore relationshi ps among them. Methods Thirty-six female SD rats, SPF grade, weighing (250 ± 25) g, were used. One hind l imb of the rat was randomly selected as experimental side to receive in situ free gracil is muscle transplantation, and the counterlateral hind l imb underwent no operation serving as control side. General condition of the rats was observed after operation. Muscle contractivecapacity and muscle wet weight maintenance rate of the experimental and the control side were detected 1, 2, 4, 10, 15, and 30 weeks after operation, and 6 rats were killed at each time point. Meanwhile, HE staining was performed to observe muscle fibre cross-sectional area, real-time quantitative PCR was appl ied to detect relative expression of MAFbx/Atrogin-1 mRNA, and Western blot test was used to observe MAFbx protein expression. Results All rats survived till the end of the experiment, all incisions healed well, and no dysfunction occurred in the experimental sides. The value of muscle contractive capacity, muscle wet weight maintenance rate, muscle’s maximal force of single contraction, and muscle’s maximal force of tetanic contraction in the experimental sides dramatically decreased in the first 4 weeks after operation and increased gradually over 4 to 30 weeks. The MAFbx mRNA expression of the experimental sides peaked and was seven times greater than the control sides 2 weeks after operation, then the value gradually decreased over 15 to 30 weeks after operation and was 1.1 to 1.5 times greater than the control sides, and significant difference was evident between the experimental sides and the control sides at each time point (P lt; 0.05). Significant difference was evident between the experimental sides and the control sides in terms of MAFbx protein expression of the muscle 1 to 15 weeks after operation according to the Western blot result (P lt; 0.05), and no significant difference was noted at 30 weeks (P gt; 0.05). The correlation coefficient between muscle wet weight maintenance rate and muscle’s maximal force of single contraction maintenance rate was 0.95, between muscle wet weight maintenance rate and muscle’s maximal force of tetanic contraction maintenance rate was 0.75, between muscle fibre cross-sectional area recovery rate and muscle’s maximal force of single contraction maintenance rate was 0.93, and between muscle fibre cross-sectional area recovery rate and muscle’s maximal force of tetanic contraction maintenance rate was 0.68 (P lt; 0.05). The correlation coefficient between MAFbx mRNA expression and the parameter of muscle wet weight maintenance rate, muscle fibre cross-sectional area recovery rate, muscle’s maximal force of single contraction maintenance rate, and muscle’s maximal force of tetanic contraction maintenance rate was — 0.62 (P lt; 0.05), — 0.45 (P gt; 0.05), — 0.72 (P lt; 0.05) and — 0.78 (P lt; 0.05), respectively; the correlation coefficient between MAFbx protein relative expression and the parameter of muscle wet weight maintenance rate, muscle fibre cross-sectional area recovery rate, muscle’s maximal force of single contraction maintenance rate, and muscle’s maximal force of tetanic contraction maintenance rate was — 0.95 (P lt; 0.05), — 0.82 (P lt; 0.05), — 0.89 (P lt; 0.05), and — 0.54 (P gt; 0.05), respectively. Conclusion Decrease of muscle function after transplantation correlates closely with muscle atrophy. The high expression of MAFbx mRNA and protein, especially their persistent increases from 4 to 15 weeks after nerve reinnervation, is a junction between the muscle atrophy and thedecrease of muscle function.

    Release date:2016-09-01 09:07 Export PDF Favorites Scan
  • 游离胸脐皮瓣修复四肢软组织缺损

    【摘 要】 目的 介绍胸脐皮瓣游离移植修复前臂和小腿软组织缺损的方法。 方法 2000年8月-2005 年12月,收治前臂和小腿软组织缺损54 例。男48 例, 女6 例;年龄13 ~ 46 岁,平均28 岁。碾压伤30 例,炸伤3 例,热压伤15 例,电击伤3 例,肿瘤切除术后3 例。前臂缺损24 例,小腿缺损30 例。缺损范围13 cm × 6 cm~ 35 cm × 15 cm。急诊手术6 例,择期手术45 例,肿瘤切除同时修复3 例。采用游离胸脐皮瓣修复缺损,皮瓣切取范围15 cm × 8 cm ~ 40 cm × 15 cm。供区1 例植皮修复,余直接缝合。 结果 术后除1 例皮瓣远端边缘部分坏死,余53 例皮瓣成活良好。供区愈合良好,植皮成活。术后皮瓣臃肿3 例,行二期皮瓣修整术。48 例获随访3 个月~ 3 年。皮瓣颜色正常,质地柔软,外观好。 结 论 游离胸脐皮瓣是修复四肢软组织缺损的有效方法之一。

    Release date:2016-09-01 09:10 Export PDF Favorites Scan
  • CLINICAL APPLICATION OF FREE PERONEAL PERFORATOR-BASED SURAL NEUROFASCIOCUTANEOUS FLAP

    【Abstract】 Objective To investigate the operative techniques and cl inical results of repairing the soft tissue defectsof forearm and hand with free peroneal perforator-based sural neurofasciocutaneous flap. Methods From May 2006 toJanuary 2007, 6 patients including 5 males and 1 female were treated. Their ages ranged from 22 years to 51 years. They were injured by motor vehicle accidents (2 cases), or crushed by machines (4 cases), with skin defect of hand in 1 case, skin defect of hand associated with tendon injuries and metacarpal fractures in 2 cases, skin defect of forearm in 2 cases, and forearm skin defects with fractures of radius and ulna in 1 case. The areas of soft tissue defect ranged from 16 cm × 7 cm to 24 cm × 10 cm. The debridement and the primary treatment to tendons or bones were performed on emergency. And free flaps were transplanted when the wound areas were stable at 4 to 7 days after the emergent treatment. During the operation, the flaps were designed along the axis of the sural nerve nutrient vessels according to the shape and size of the soft tissue defects, with the peroneal perforator above the lateral malleolus as the pedicle and along with a part of the peroneal artery for vascula anastomosis. Then the flaps were harvested and transferred to the reci pient sites with the peroneal vartey anastomosed to the radial (or ulnar) artery and the peroneal veins to one of the radial (or ulnar) veins and the cephal ic vein, respectively. The flap size ranged from 18 cm × 8 cm to 25 cm × 12 cm. The donor areas were closed by skin grafts. Results The 5 flaps survived after the surgery. Partial inadequate venous return and distal superficial necrosis happened in only 1 case, which also got secondary heal ing by changing dressing and anti-infective therapy. The donor sites reached primary heal ing completely. The followed-up in all the patients for 6 to 13 months revealed that the appearance and function of the flaps were all satisfactory, and no influence on ambulation of donor site was found. Conclusion Peroneal perforator-based sural neurofasciocutaneous flap has the advantages of favourable appearance, constant vascular pedicle, rel iable blood supply, large size of elevation and minor influence on the donor site. And the free transfer of this flap is an ideal procedure to repair the large soft tissue defects of forearm and hand.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • 腓骨近端游离移植重建桡骨远端骨巨细胞瘤切除后骨缺损

    【摘 要】 目的 总结桡骨远端骨巨细胞瘤(giant cell tumor,GCT)切除后自体腓骨近端游离移植修复重建方法及效果。 方法 1997 年3 月- 2005 年3 月,对7 例桡骨远端GCT 患者行瘤段切除、自体腓骨近端游离移植修复重建术,其中男2 例,女5 例;年龄31 ~ 55 岁。术前腕关节平均活动度:掌屈37°,背伸30°,桡偏9°,尺偏15°;前臂旋前58°,旋后61°。影像学检查示肿瘤范围为4 cm × 3 cm × 3 cm ~ 8 cm × 6 cm × 4 cm。按改良Campanacci 影像学分级系统对GCT 进行分级,Ⅱ级5 例,Ⅲ级2 例。病理骨折3 例,所有患者桡骨远端骨质破坏均超过50% 。 结果 术后7 例患者均获随访,随访时间6 ~ 48 个月,平均16 个月。未发现肿瘤局部复发和远处转移,术后无感染、骨吸收和骨不愈合。移植腓骨全部成活,骨愈合时间10 ~ 14 周。重建腕关节外观及功能良好,腕关节平均活动度:掌屈40°,背伸36°,桡偏14°,尺偏20°,前臂旋前52°,旋后48°。根据肌肉骨骼肿瘤学会保肢评分标准进行功能评价,本组优3 例,良3 例,可1 例。 结 论 腓骨近端游离移植对桡骨远端肿瘤切除后骨缺损的重建是一良好的选择,远期效果尚待进一步观察。

    Release date:2016-09-01 09:14 Export PDF Favorites Scan
  • 股前外侧皮瓣在口腔肿瘤术后缺损修复中的初步应用

    目的 总结股前外侧皮瓣(anterolateral thigh flap,ALT)修复口腔肿瘤切除术后缺损的临床效果。方法 2005 年6 月- 2007 年6 月,采用ALT 修复14 例口腔癌术后缺损。男8 例,女6 例;年龄21 ~ 69 岁。下牙龈鳞癌3 例,侧口底鳞癌3 例,上腭或上牙龈鳞癌3 例,上腭黏液表皮样癌不全术后1 例,舌根鳞癌4 例。病程1 ~ 5 个月。分别采用单纯手术6 例,诱导化疗、手术联合放疗5 例,手术联合放疗3 例。肿瘤切除后缺损范围6 cm × 4 cm ~ 12 cm × 9 cm,皮瓣切取范围7 cm × 5 cm ~ 14 cm × 10 cm。供区直接缝合。术中1 例发现穿支血管缺如,1 例损伤穿支血管改用前臂皮瓣。 结果 术后14 例皮瓣均成活,供、受区切口均Ⅰ期愈合。14 例均获随访,随访时间5 ~ 29 个月。皮瓣外形均满意,吞咽、发音等功能恢复良好。1 例上腭癌术后6 个月复发,放疗后至今带瘤生存8 个月;1 例上腭癌术后5 个月出现第3 原发癌,化疗后生存8 个月;其余12 例无瘤生存。 结论 ALT 手术成功率较高,组织量丰富,适用于较大缺损修复,对供区影响小,修复后受区功能良好,可安全地用于口腔软组织缺损修复。

    Release date:2016-09-01 09:17 Export PDF Favorites Scan
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