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find Keyword "皮肤脱套伤" 7 results
  • REPAIR OF DEGLOVING INJURY OF FINGERTIP WITH VASCULAR PEDICLED CROSS FINGER FLAP

    Objective To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingertip. Methods Between January 2010 and June 2012, 13 cases of degloving injury of single fingertip were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was beyond the distal interphalangeal joint. The length of the avulsion was 1.0-2.1 cm (mean, 1.8 cm). Complicated injuries included phalangeal fracture in 2 cases. The time from injury to operation was 90-330 minutes (mean, 150 minutes). The wound was repaired with the cross finger flap pedicled with the dorsal branch of proper digital artery. The size of flaps ranged from 3.2 cm × 2.3 cm to 4.2 cm × 3.1 cm. After 3-4 weeks, the pedicle was cut. The donors were closed by skin graft. Results Tension blisters of the flap and partial necrosis of skin graft occurred in 3 cases and in 1 case respectively, which were cured after symptomatic treatment; the flap and skin graft survived, and primary healing was obtained in the other cases. Thirteen patients were followed up 6-10 months (mean, 7 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination ranged from 7 to 10 mm (mean, 8.1 mm). The total active movement of the fingers were excellent in 10 cases and good in 3 cases, and the excellent and good rate was 100%. Conclusion The treatment of degloving injury of fingertip with the cross finger flap pedicled with the dorsal branch of proper digital artery is recommendable for the advantages of reliable blood supply, simple operation, high survival rate of the flap, good function recovery of the finger, and satisfactory appearance.

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • CLASSIFICATION AND TREATMENT OF WHOLE HAND DEGLOVING INJURY

    Objective To summarize the injury characteristics of the whole hand degloving injury and to explore its classification and treatment. Methods Between December 1999 and May 2010, 41 cases of the whole hand degloving injury were admitted for treatment. There were 28 males and 13 females with an average age of 35 years (range, 18-58 years). The causesof injury included mangled injury in 28 cases and crush injury in 13 cases. The interval between injury and surgery was 1-10 hours (mean, 3 hours). According to self-made classification standard for whole hand degloving injury, 11 cases were rated as type I, 5 cases as type II, 4 cases as type III, 8 cases as type IV, and 13 cases as type V. Type I injury was treated by replantation surgery with vascular anastomosis, type II by reconstruction with thumb flap and the second toe containing dorsal skin flap, type III by reconstruction with the second toe containing dorsal skin flap of both feet, type IV by replantation surgery with vascular anastomosis, and type V by reconstruction with thumb flap containing dorsal skin flap (8 cases) or repairing with abdominal flap (5 cases). The size of the dorsal flap was between 9 cm × 6 cm and 17 cm × 11 cm and the dorsal donor site was covered with free skin grafting. Results After surgery, partial necrosis occurred at fingers in 6 patients with type I injury, and at fingers and palm skin in 6 patients with type IV injury; the flaps, the reconstructed fingers, and replanted skin all survived in the others. The grafted skin at donor sites successfully healed. Forty cases were followed up from 6 months to 7 years (mean, 14 months). The skin color and texture were close to normal hand in the cases undergoing replantation, who had the best function restoration with S2-S4 sensory recovery; the hand function was basically restored with S2-S3 sensory recovery in the cases undergoing finger reconstruction with thumb and toe flaps; and the restoration of the hand function was not satisfactory with S1-S2 sensory recovery in the cases undergoing abdominal flaps. Conclusion Whole hand degloving injury can be classified into different types according to injury degree and this will help choose the cl inical treatment plan. The appropriate treatment based on these types can obtain better cl inical effectiveness.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 皮肤回植联合封闭式负压引流技术治疗四肢皮肤脱套伤

    目的 总结封闭式负压引流技术(vaccum sealing drainage,VSD)联合一期皮肤回植治疗四肢皮肤脱套伤的临床效果。 方法 2009 年3 月- 2010 年3 月,采用VSD 联合一期皮肤回植修复25 例四肢皮肤脱套伤患者。男16 例,女9 例;年龄9 ~ 53 岁,中位年龄32 岁。致伤原因:交通事故伤19 例,高处坠落伤3 例,重物砸伤3 例。部位:手背3 例,前臂6 例,小腿10 例,足踝及足背 6 例。脱套范围为14 cm × 9 cm ~ 42 cm × 23 cm。合并骨折8 例,血管、神经损伤2 例。受伤至入院时间4 ~ 8 h。 结果  22 例经7 ~ 10 d VSD 治疗后,回植皮肤顺利成活;3 例经VSD 治疗10 d 后仍有点状坏死,经换药后愈合。25 例均获随访,随访时间3 ~ 12 个月,平均9 个月。全厚皮片回植后颜色接近正常皮肤,弹性良好,质地柔软,小腿两点辨别觉2 ~ 3 cm;中厚皮回植后部分颜色发暗,质地较硬,小腿两点辨别觉6 ~ 8 cm。8 例合并骨折者骨折愈合时间3 ~ 8 个月,平均5 个月;1 例尺神经断裂者6 个月后骨间肌萎缩,另1 例血运、感觉、运动均较好。 结 论 急诊VSD 在治疗四肢皮肤脱套伤中能充分引流、均匀加压、改善血循环、促进脱套皮肤成活。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • 吻合静脉加负压引流治疗全手掌皮肤脱套伤

    目的 总结吻合静脉加负压引流治疗全手掌皮肤脱套伤的治疗方法和临床效果。 方法 2005 年6 月- 2007 年9 月,收治全手掌皮肤脱套伤7 例。男5 例,女2 例;年龄17 ~ 45 岁,平均30 岁。机器压伤5 例,滚轴绞伤2 例。手掌、手背自腕横纹逆行脱套至指蹼。受伤至手术时间为1 ~ 6 h,平均3 h。术中吻合皮下静脉、重建静脉回路,伤口内放置负压引流进行原位修复。 结果 6 例脱套皮肤全部成活;1 例脱套皮肤远端掌侧部分坏死,行游离植皮后成活。7 例均获随访,随访时间3 ~ 17 个月,平均12 个月。手部外形及色泽基本正常,出汗正常,手指屈、伸及感觉功能恢复良好。按中华医学会手外科学会上肢部分功能评定试用标准:获优3 例,良3 例,差1 例,优良率85.7%。 结论 吻合静脉加负压引流可以减轻皮肤水肿,提高脱套皮肤的成活率,是治疗全手掌皮肤脱套伤的一种较好方法。

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • 双侧股前外侧皮瓣瓦合修复全足皮肤脱套伤

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • MICROSURGICAL REPAIR OF SKIN-DEGLOVING INJURY OF WHOLE HAND OR FOOT

    OBJECTIVE: To investigate the clinical effects of the microsurgical treatment for the skin-degloving injury of the whole hand or foot. METHODS: From March 1984 to October 2001, we treated 6 cases of skin-degloving injury of the whole hand and foot. In 2 cases of skin-degloving hands, one was treated with free great omentum transplantation plus skin graft, the other with pedical abdominal S-shaped skin flap as well as mid-thick skin graft. In 4 cases of skin-degloving injury of the foot, 2 cases was repaired with free latissimus dosi musculocutaneous flap, 1 case with distall-based lateral skin flap of the leg and 1 case with free tensor fasciae latae muscle flap. The flap size ranged from 7 cm x 9 cm to 22 cm x 15 cm. One case was operated on the emergency stage, the other 5 cases on the delayed stage. The delayed time ranged from 2 to 14 days with an average of 6.6 days. RESULTS: All the flaps survived. After 1-2 year follow-up, the appearance and function of the hand and the foot were good. CONCLUSION: Microsurgery technique in repairing skin-degloving injury of the whole hand and foot can achieve good results. The keys to success are thorough debridement of the recipient area, appropriate selection of the donor site, good vascular anastomosis and active postoperative rehabilitation.

    Release date:2016-09-01 09:35 Export PDF Favorites Scan
  • EFFECTIVENESS COMPARISON BETWEEN TWO KINDS OF PROCEDURES FOR TREATMENT OF TOTALLY DEGLOVED HAND

    ObjectiveTo compare the effectiveness between toe transfer combined with an abdominal flap and bag-shaped abdominal flap for treatment of totally degloved hand. MethodsBetween January 2005 and January 2012,18 patients with totally degloved hand were treated by two kinds of techniques.Those patients were divided into 2 groups according to the technique.The bag-shaped abdominal flap was used in 8 cases (group A),and toe transfer with a dorsalis pedis skin flap combined with abdominal S-shaped tile-joint subdermal vascular network flaps was performed in 10 cases (group B).There was no significant difference in gender,age,injury cause,injury degree,and interval between injury and operation between 2 groups (P>0.05).The static two-point discrimination (s2PD),grip power of the reconstructed hand,time of returning to work,and active total range of motion (ROM) of the operated finger were compared between 2 groups to assess the effectiveness. ResultsAll flaps and skin grafts survived in 2 groups.One flap suffered vascular crisis at 2 days after operation and survived after surgical exploration in group B.All patients were followed up 12-24 months (mean,16 months).At last follow-up,group B showed a better recovery of s2PD of the thumb and ROM,and shorter time of returning to work than group A (P<0.05),but no significant difference was found in grip power of the reconstructed hand and s2PD of the other fingers between 2 groups (P>0.05). ConclusionThe technique of toe transfer combined with an abdominal flap is better than traditional bag-shaped abdominal flap with the advantages of easy dissection,less time of operation,and satisfactory functional recovery.

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