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find Keyword "皮下" 72 results
  • Application of Abdominal Wall Closure Measure Without Suturing Subcutaneous Fat Layer in Abdominal Surgery

    Objective To compare the efficacy of incision healing by abdominal wall closure measure without suturing subcutaneous fat layer and the traditional abdominal wall closure measure. Methods Four hundreds patients underwent operation of abdominal median incision and abdominal paramedian incision from Sep. 2010 to Sep. 2012 in our department were randomly assigned to observation group (n=199) and control group (n=201). The patients in obser- vation group underwent abdominal wall closure measure without suturing subcutaneous fat layer, and those of control group were subjected to abdominal wall closure by traditional layer suture technique. Comparison of efficacy of incision healing in the 2 groups was performed. Results The incidences of fat liquefication 〔1 (0.5%) vs.18 (9.0%)〕, incision swelling 〔3 (1.5%) vs.16 (8.0%)〕, incision induration 〔1 (0.5%) vs.15 (7.5%)〕, and dehiscence of wound 〔0 (0) vs.9 (4.5%)〕 in observation group were significantly lower than those of control group (P<0.01), but there was no significant difference in incidence of subcutaneous hematoma 〔2 (1.0%) vs.0 (0), P>0.05〕. The rate of primary healing in obser-vation group was significantly higher than those of control group 〔199 (100%) vs.186 (92.5%), P<0.01〕. Duration of abdominal closure 〔(13.0±1.6) min vs.(18.0±2.2) min〕 and postoperative hospital stay 〔(7.7±1.3) days vs.(9.6±1.9) days〕 were all shorter than those of control group (P<0.01). Conclusion The abdominal wall closure measure without suturing subcutaneous fat layer is obviously more effective to the traditional layer suture technique, which is a suture way worthy to spread.

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  • Application of Ultracision Harmonic Scalpel and Skin Flap in Axillary Fossa External Fixation on Breast Cancer Operation . 

    Objective To study the role of ultracision harmonic scalpel and skin flap in axillary fossa external fixation in operation of breast cancer. Methods One hundred and sixty-six patients with breast cancer were included in this study between May 2009 and November 2009. Combined group (n=51) applied ultracision harmonic scalpel combined with skin flap external fixation. External fixation group (n=52) used the skill of skin flap external fixation. Routine group included 63 patients. Operative time, accidental injury during operation, volume of bleed and drainage, time of drainage, detection amount of lymph node, and complications such like subcutaneous fluidity were observed and recorded. Results The operative time and detection amount of lymph node were not different among three groups (Pgt;0.05). The volume of bleed in combined group was less than that in other groups (Plt;0.05). The volume of drainage and the time of drainage were decreased or shorten by turns from routine group, external fixation group to combined group (Plt;0.05). The incidence rate of subcutaneous fluidity in combined group was lower than that in routine group (Plt;0.05). Conclusions Using ultracision harmonic scalpel in operation of breast cancer can remarkably reduce the volume of bleed and drain postoperatively. Ultracision harmonic scalpel combined with skin flap external fixation is safety and can reduce the incidence rate of subcutaneous fluidity, thus can be applied widely in breast cancer operation.

    Release date:2016-09-08 10:49 Export PDF Favorites Scan
  • Application of Portosystemic Shunt After Subcutaneous Transposition of the Spleen to Orthotopic Liver Transplantation in the Rat

    ObjectiveTo evaluate the application of portosystemic shunt after subcutaneous transposition of the spleen (STS) to orthotopic liver transplantation (OLT) in the rat. MethodsOne hundred and eighty Wistar rats were randomly divided into the group of orthotopic liver transplantation after portosystemic shunts by subcutaneous transposition of the spleen (STS+OLT group) and the group of orthotopic liver transplantation (OLT group). The two groups were further divided into A, B, C subgroups in the light of duration of anhepatic phase (phases were respectively less than 25 min, around 35 min and 45 min).There were fifteen rats in each subgroup. At the described intervals, blood samples were collected from the peripheral and portal vein for testing ALT, pH and endotoxin levels. The survival rates were also observed. Results The ALT value of all animals basically returned to normal levels on the 7th postoperative day in the STS+OLT group and the OLT A subgroup, but in OLT B subgroup, ALT was still remarkably elevated on the 7th postoperative day (P<0.01), and returned to normal levels on the 30th postoperative day. The pH values and endotoxin levels from the portal vein of all animals in STS+OLT groups and OLT A subgroup had no significant difference (Pgt;0.05) at the beginning, the end of the anhepatic phase and at the time of reperfusion for 30 min. But in the OLT B and C groups, the pH values and endotoxin levels were significantly higher at the end of anhepatic phase and reperfusion for 30 min than those in the beginning of anhepatic phase (P<0.01). The survival rates at postoperative different time points in both B and C subgroup of the OLT group were significantly lower than those in STS+OLT group animals (P<0.05).Conclusion The portosystemic shunt by subcutaneous transposition of the spleen can notably improve both the success rate of the OLT procedure and the postoperative survival rate in the rat.

    Release date:2016-08-28 05:11 Export PDF Favorites Scan
  • 百草枯中毒致纵隔、皮下气肿及气胸一例

    纵隔、皮下气肿及气胸是百草枯中毒后的一种严重、预后极差的并发症,临床少见。本院收治1例,现报告如下。

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
  • Comparative Study on the Efficacy and Safety of Thrombolysis and Anticoagulation Therapy for Patients with Acute Sub-Massive Pulmonary Thromboembolism

    Objective To compare the clinical efficacy and safety of thrombolysis with anticoagulation therapy for patients with acute sub-massive pulmonary thromboembolism. Methods The clinical data of 84 patients with acute sub-massive pulmonary thromboembolism were analyzed retrospectively, mainly focusing on the in-hospital efficacy and safety of thrombolysis and/ or anticoagulation. The efficacy was evaluated based on 6 grades: cured, markedly improved, improved, not changed, deteriorated and died. Results Among the 84 patients,49 patients received thrombolysis and sequential anticoagulation therapy( thrombolysis group) , 35 patients received anticoagulation therapy alone( anticoagulation group) . As compared with the anticoagulation group, the thrombolysis group had higher effective rate( defined as patients who were cured, markedly improved or improved, 81. 6% versus 54. 3%, P = 0. 007) , lower critical event occurrence ( defined as clinical condition deteriorated or died, 2. 0% versus 14. 3% , P = 0. 032) . There was no significant difference in bleeding rates between the two groups ( thrombolysis group 20. 4% versus anticoagulation group 14. 3% , P gt; 0. 05) . No major bleeding or intracranial hemorrhage occurred in any of the patients. Conclusions Thrombolysis therapy may be more effective than anticoagulation therapy alone in patients with acute sub-massive pulmonary thromboembolism, and thus warrants further prospective randomized control study in large population.

    Release date:2016-09-14 11:22 Export PDF Favorites Scan
  • 皮下包埋二期重建指腹治疗甲根部断指

    目的 总结皮下包埋二期重建指腹治疗甲根部断指的疗效。 方法2009年8月-2011年6月,收治10例12指甲根部离断伤患者。男6例,女4例;年龄18~34岁,平均25岁。损伤指别:拇指1例,示指2例,中指5 例,环指3例,小指1例。断指按Ishikawa等分区标准均为Ⅱ区。末节掌侧缺损范围1.5 cm × 1.0 cm~2.5 cm × 2.0 cm。伤后至手术时间2~10 h,平均3.7 h。采用腹部皮下包埋回植的指骨及甲床,二期带神经的指动脉皮瓣重建指腹方法治疗,皮瓣切取范围1.8 cm × 1.2 cm~3.0 cm × 2.5 cm。 结果术后皮瓣均顺利成活。9例伤口Ⅰ期愈合;1例远端甲床部分坏死出现骨外露,行残端修整术后愈合。患者均获随访,随访时间6~24个月,平均12个月。患指长度与健侧接近,指甲生长平整,指腹饱满,质地柔软,弹性良好。皮瓣两点辨别觉6~9 mm,平均7.5 mm。术后复查X线片示回植指骨密度与健指接近,骨折愈合时间1~2.5个月,平均1.8个月,手指各关节活动正常。术后6个月手指功能按照中华医学会手外科学会上肢部分功能评定试用标准,获优5例,良4例,可1例。 结论应用皮下包埋回植指骨及甲床,二期重建指腹的方法修复断指,为无再植条件的甲根部离断伤提供了一种新的修复方法。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • APPLICATION OF NARROW HYPODERMAL PEDICLED RETROAURICULAR FLAP IN REPAIRINGPREAURICULAR SOFT TISSUE DEFECT

    Objective To investigate the technique and effectiveness of using narrow hypodermal pedicled retroauricular flap for repairing preauricular soft tissue defect. Methods Between June 2008 and July 2011, 11 cases of preauricular soft tissue defect were treated, which were caused by resection of preauricular tumors, including 5 cases of pigmented nevus, 2 cases of basal cell carcinoma, 2 cases of mixed hemangioma, and 2 cases of skin papilloma. There were 7 males and 4 females, aged from 26 to 75 years (mean, 50 years). The disease duration was 3-50 years (mean, 35 years). The size ofthe soft tissue defect ranged from 1.5 cm × 1.0 cm to 3.5 cm × 3.0 cm. The narrow hypodermal pedicled retroauricular flap was designed with its pedicle along the pathway of the superficial temporal artery and posterior auricular artery through tunnel to repair the defects. The size of the flaps ranged from 1.8 cm × 1.3 cm to 3.8 cm × 3.3 cm with the pedicle of 2-5 cm in length and 0.4-0.7 cm in width. The donor site was sutured directly or repaired with local flap. Results All flaps survived and incisions healed primarily after operation. Eight cases were followed up 6 months to 1 year. The flaps had good texture, flexibil ity, and color, and the auricle appearance was satisfactory. No recurrence of tumor was found. Conclusion The narrow hypodermal pedicled retroauricular flap has long and narrow pedicle, big transferring angle, large repairing area, no major blood vessel, and easy operation, so it is a simple and ideal technique for repairing preauricular soft tissue defect.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • CLINICAL STUDY ON ABDOMINAL EXPANDED SUBDERMAL VASCULAR PLEXUS SKIN FLAPS FORREPAIRING DORSAL HAND SCAR

    Objective To explore the method and effectiveness of abdominal expanded subdermal vascular plexus skin flaps in repairing dorsal hand scar. Methods Between May 2005 and October 2010, 16 cases of dorsal hand scars weretreated with the abdominal expanded flaps. There were 13 males and 3 females, aged 22.5 years on average (range, 10-35 years). Defect was caused by burn in 10 cases, hot crush injury in 4 cases, and scald injury in 2 cases. The average scar formation was 21 months (range, 1 year and 6 months to 2 years). The patients had flexion restriction of metacarpophalangeal joint and interphalangeal joint. The scar size ranged from 11 cm × 7 cm to 18 cm × 10 cm. The expander was implanted in abdominal skin and inflated with water regularly at the first stage. After 2 weeks, the expanded pedicled flap was trasferred to repair wounds in which scars were excised. The flap size ranged from 12 cm × 9 cm to 19 cm × 12 cm. After being cut off the pedicle at 14 days, the fingers were divided, and the digital web was formed. The abdominal donor site was directly sutured. Results All flaps survived. The wound and donor site achieved primary heal ing. Sixteen cases were followed up 1 year and 2 months to 3 years with an average of 2 years and 3 months. The flaps had soft texture and good flexibil ity. At last follow-up, hand function was graded as excellent in 13 cases, good in 2 cases, and poor in 1 case with an excellent and good rate of 93.7% according to the total active motion evaluation system. Conclusion Abdominal expanded subdermal vascular plexus skin flap is an effective method to repair large scar of the dorsal hand because it has satisfactory texture, fast rebuilding of blood supply, and large area of survival.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • EFFECTIVENESS COMPARISON BETWEEN TWO DIFFERENT METHODS OF ANTERIOR TRANSPOSITION OF THE ULNAR NERVE IN TREATMENT OF CUBITAL TUNNEL SYNDROME

    Objective To compare the effectiveness of anterior subcutaneous transposition and anterior submuscular transposition of the ulnar nerve in the treatment of cubital tunnel syndrome. Methods Between June 2006 and October 2008, 39 patients with cubital tunnel syndrome were treated separately by anterior subcutaneous transposition (anterior subcutaneous transposition group, n=20) and anterior submuscular transposition (anterior submuscular transposition group, n=19). There was no significant difference in gender, age, duration, and cl inical classification between 2 groups (P gt; 0.05). Results All incisions healed by first intention in 2 groups. In anterior submuscular transposition group, 17 patients (89.5%) had abruptly deteriorated symptoms after the symptom of ulnar nerve compression was abated, and 1 patient (5.3%) had cicatrix at elbow; in the anterior subcutaneous transposition group, 10 patients (50.0%) had disesthesia at cubital anterointernal skin after operation; and there was significant difference in the complication between 2 groups (χ2=9.632, P=0.002). The patients were followed up 24 to 36 months, 28 months on average. There was no significant difference in grip strength, pinch power of thumb-to-ring finger and thumb-to-little finger, or two-point discrimination of distal l ittle fingers between 2 groups (P gt; 0.05), but significant differences were found between before operation and after operation in 2 groups (P lt; 0.05). According to the Chinese Medical Society of Hand Surgery Trial upper part of the standard evaluation function assessment, the results were excellent in 5 cases, good in 12 cases, fair in 1 case, and poor in 2 cases in the anterior subcutaneous transposition group; the results were excellent in 6 cases, good in 10 cases, fair in 2 cases, and poor in 1 case in the anterior submuscular transposition group; and there was no significant difference between 2 groups (u=0.346, P=0.734). According to disabil ity of arm-shoulder-hand (DASH) questionnaires, the score was 22 ± 7 in anterior subcutaneous transposition group and was 19 ± 6 in anterior submuscular transposition group, showing no significant difference (t=1.434, P=0.161). Conclusion Both anterior subcutaneous transposition and anterior submuscular transposition have good effectiveness in treating cubital tunnel syndrome; and anterior submuscular transposition has less complication than that of submuscular transposition.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 双侧鼻底皮下蒂皮瓣修复鼻小柱缺损疗效

    目的 总结采用双侧鼻底皮下蒂皮瓣修复鼻小柱皮肤软组织缺损的方法及疗效。 方法 2010 年6 月- 12 月,采用双侧鼻底皮下蒂皮瓣移位修复鼻小柱皮肤软组织缺损7 例。男2 例,女5 例;年龄17 ~ 38 岁,平均26岁。其中鼻小柱黑毛痣2 例,鼻唇瘢痕挛缩畸形2 例,自觉鼻尖圆钝、低平、鼻小柱短小3 例。术中测得鼻小柱皮肤软组织缺损范围为0.5 cm × 0.4 cm ~ 1.2 cm × 0.8 cm,单侧鼻底皮下蒂皮瓣切取范围为0.4 cm × 0.3 cm ~ 1.4 cm × 0.5 cm。供区直接拉拢缝合。 结果 1 例术后第2 天出现皮瓣青紫、水肿,经对症处理后成活;其余皮瓣均顺利成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合。患者均获随访,随访时间6 ~ 11 个月,平均8 个月。拆线后皮瓣均有毛发生长,于术后6 个月行激光脱毛处理。鼻前庭、鼻孔形态无改变,皮瓣与受区皮肤色泽、质地相似,无明显瘢痕,延长的鼻小柱形态自然。 结论 双侧鼻底皮下蒂皮瓣是修复鼻小柱皮肤软组织缺损较好方法之一,具有供区瘢痕隐蔽,皮瓣质地、色泽与受区无明显差异等优点。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
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