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find Keyword "穿支" 178 results
  • 第四腰动脉穿支皮瓣治疗骶尾部小面积褥疮

    目的总结第4腰动脉穿支皮瓣修复骶尾部小面积褥疮的疗效。 方法2002 年1月-2012年10月,采用第4腰动脉穿支皮瓣修复骶尾部小面积褥疮17例。男11例,女6例;年龄23~84岁,平均71.6岁。褥疮根据美国国家压疮专家组(NPUAP)分度标准:Ⅲ度8例,Ⅳ度9例。病程30 d~9个月,平均2.5个月。褥疮范围5 cm × 4 cm~7 cm × 5 cm。皮瓣切取范围15 cm × 8 cm~17 cm × 10 cm。供区直接缝合。 结果术后1例皮瓣边缘坏死、1例切口愈合不良合并轻度感染,均经对症治疗后愈合;其余皮瓣完全成活,创面Ⅰ期愈合。供区1例切口边缘皮肤坏死,经换药愈合;其余切口均Ⅰ期愈合。1例术后2个月余因股骨粗隆间骨折合并肺部感染死亡;余16例获随访,随访时间3 个月~2年,平均6.4个月。皮瓣质地优良,外形满意,皮肤颜色及弹性均恢复较好,术后3个月皮瓣触、痛觉与周围正常皮肤相似。褥疮无复发。 结论第4腰动脉穿支皮瓣设计简便、血供可靠、不损伤臀部肌肉、供区无需植皮,术后褥疮复发率低,是修复骶尾部小面积褥疮的有效方法之一。

    Release date:2016-08-31 10:53 Export PDF Favorites Scan
  • PEDICLED SUPERIOR GLUTEAL ARTERY PERFORATOR BILATERAL QUADRILOBED FLAPS FOR REPAIR OF LARGE SACROCOCCYGEAL PRESSURE SORES

    Objective To investigate the effectiveness of pedicled superior gluteal artery perforator bilateral quadrilobed flaps for repairing large sacrococcygeal pressure sores. Methods Between June 2003 and August 2011, 6 paraplegia patients with large sacrococcygeal pressure sores were repaired with the pedicled superior gluteal artery perforator bilateral quadrilobed flaps. There were 2 males and 4 females with an average age of 45.6 years (range, 37-62 years). The mean disease duration was 8.4 months (range, 3-26 months). According to National Pressure Ulcer Advisory Panel (NPUAP) standard, 6 cases rated as degree IV. The size of pressure sores ranged from 15 cm × 13 cm to 18 cm × 16 cm. The size of flaps ranged from 18 cm × 14 cm to 21 cm × 15 cm. Results After operation, all flaps survived successfully. The wounds healed by first intention in 5 cases; partial dehiscence of incision occurred in 1 case, which was cured after dressing change for 26 days. Six patients were followed up 6-24 months (mean, 12.5 months). The appearance and texture of the flaps were smooth and soft with good elasticity and no ulceration. Conclusion Pedicled superior gluteal artery perforator bilateral quadrilobed flaps can repair large sacrococcygeal pressure sores. The appearance of flaps is smooth and has good compression-resistance effect.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • APPLICATION OF HIGH FREQUENCY COLOR DOPPLER ULTRASOUND IN ANTEROLATERAL THIGH FLAP SURGERY

    Objective To investigate the effectiveness of high frequency color Doppler ultrasound for detecting perforators in the anterolateral thigh (ALT) flap surgery. Methods Between February 2011 and July 2012, 8 patients underwent high frequency color Doppler ultrasound to detect the perforator anatomy before ALT flap surgery. There were 5 males and 3 females, aged 21-46 years (mean, 34 years). Defects were caused by excision of squamous cell carcinoma in 2 cases, by scalp avulsion in 2 cases, by soft tissue necrosis after neck trauma in 1 case, by excision of groin fibrosarcoma in 1 case, by excision of groin melanoma in 1 case, and by malformation of the face in 1 case. The defect size varied from 12 cm × 7 cm to 22 cm × 18 cm. The perforator with wider caliber, faster flow speed, and shorter intramuscular trajectory was selected, and the flap was designed according to the observed results, which size varied from 14 cm × 9 cm to 25 cm × 20 cm. The donnor sites were repaired by free skin graft. Results Totally, 19 perforators in the flap area were detected by high frequency color Doppler ultrasound, and 18 were identified during operation, with an accuracy rate of 94.7%. The point going out muscle, the travel and direction of perforators observed during operation were basically in accordance with those detected by high frequency color Doppler ultrasound. The other flaps survived, and obtained healing by first intention except 1 flap which had partial fat necrosis with healing by second intention. The skin graft at donor site survived. All patients followed up 4-16 months (mean, 8 months). The flaps had good color and texture. Conclusion High frequency color Doppler ultrasound is a valuable imaging modality for the preoperative assessment of the vascular supply for ALT flap.

    Release date:2016-08-31 04:06 Export PDF Favorites Scan
  • 游离股前外侧动脉穿支皮瓣及腓动脉穿支皮瓣在足踝部创面中的应用

    目的总结采用游离股前外侧动脉穿支皮瓣及腓动脉穿支皮瓣修复足踝部创面的疗效。 方法2006年8月-2010年7月,收治21例足踝部开放性损伤患者。男15例,女6例;年龄21~57岁,平均37岁。致伤原因:交通事故伤12例,重物砸伤7例,高处坠落伤2例。伤后至手术时间1个月~2年。创面软组织缺损范围3.5 cm × 3.0 cm~25.0 cm × 15.0 cm,均伴足踝部骨折。创面分泌物细菌培养示11例阳性。采用游离股前外侧动脉穿支皮瓣(16例)或腓动脉穿支皮瓣(5例)修复,皮瓣切取范围3.5 cm × 3.0 cm~25.0 cm × 15.0 cm。供区游离植皮或直接拉拢缝合。 结果术后皮瓣及供区植皮均顺利成活;创面Ⅰ期愈合19例,延期愈合2例。患者均获随访,随访时间6个月~2年,平均16个月。皮瓣质地及外观满意,末次随访时皮瓣两点辨别觉为21~29 mm。下肢肢体功能评定,获优10例,良8例,可3例, 优良率为85.7%。 结论根据创面大小及部位选择游离股前外侧动脉穿支皮瓣和腓动脉穿支皮瓣修复足踝部创面可获得满意疗效。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • V-Y ADVANCEMENT OF SKIN FLAP PEDICLED WITH UPPER LIMB LATERAL BRANCH FOR SMALL SKIN DEFECT IN THE DORSAL ELBOW

    【Abstract】 Objective To research the method and effectiveness of V-Y advancement of skin flap pedicled with the upper limb lateral branch in the treatment of small skin defect in the dorsal elbow. Methods Between March 2008 and August 2010, 6 cases of skin defect in the dorsal elbow were treated by V-Y advancement of skin flap pedicled with the upper limb lateral branch, including 4 males and 2 females with a mean age of 53 years (range, 16-76 years). Defects were caused by crushing in 3 cases, by punching in 2 cases, and the disease duration was 4 hours 30 minutes to 7 days (mean, 29.5 hours); and by chronic infection in 1 case, and the disease duration was 12 months. The defect size ranged from 4.0 cm × 2.5 cm to 9.5 cm × 3.5 cm, all complicating by bone or tendon exposure. The flap size ranged from 6.0 cm × 4.0 cm to 12.5 cm × 9.5 cm; the donor sites were sutured directly. Results All flaps survived completely, wounds and incisions at donor sites healed by first intention. Six cases were followed up 6-12 months after operation. The flaps had good texture and color. Two-point discrimination of the skin flap was 12-16 mm. The function of limb was normal, and elbow flexion and extension activity averaged 105° (range, 95-125°). Conclusion It is ideal to treat small skin defect in the dorsal elbow with V-Y advancement of skin flap pedicled with the upper limb lateral branch because of easier operation and less injury at donor site.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 第一掌骨桡背侧穿支皮瓣修复拇指背岛状皮瓣供区

    目的 总结第1掌骨桡背侧穿支皮瓣修复拇指背岛状皮瓣供区的疗效。 方法 2010年1月-2012年7月,收治21例拇指软组织缺损患者。男13例,女8例;年龄17~56岁,平均32.3岁。指端缺损7例,指腹缺损10例,甲床缺损4例。创面范围1.5 cm × 1.5 cm~2.0 cm × 1.8 cm。受伤至入院时间20 min~14 h,平均4.6 h。采用大小为1.8 cm × 1.8 cm~2.3 cm × 2.0 cm的近节指背岛状皮瓣修复创面后,利用大小为1.3 cm × 1.1 cm~2.0 cm × 1.5 cm的第1掌骨桡背侧穿支皮瓣修复供区,穿支皮瓣供区直接缝合。 结果术后拇指背岛状皮瓣和第1掌骨桡背侧穿支皮瓣均顺利成活,创面Ⅰ期愈合。19例获随访,随访时间5~17个月,平均10.4个月。皮瓣血运、弹性好,手指无疼痛。末次随访时,供区皮瓣两点辨别觉为8~12 mm,平均9.6 mm。拇指对掌、对指功能正常。根据中华医学会手外科学会断指再植功能评定试用标准,获优16例,良3例,优良率100%。 结论采用第1掌骨桡背侧穿支皮瓣修复拇指背岛状皮瓣供区,避免植皮后掌指关节背侧瘢痕挛缩,最大限度保留掌指关节功能,穿支皮瓣供区可直接缝合,是一种有效术式。

    Release date:2016-08-31 04:12 Export PDF Favorites Scan
  • REPAIR OF FACE AND UPPER LIMB DEFECTS WITH EXPANDED DELTO-PECTORAL AND ABDOMINALPERFORATOR FLAPS

    【Abstract】 Objective To investigate the method and effectiveness of expanded delto-pectoral and abdominalperforator flaps in repairing large defects of the face and upper limb after scar excision. Methods Between August 2000 and February 2011, 25 patients with large scars on face and upper l imb were treated. There were 14 males and 11 females with an average ageof 27 years (range, 7-36 years). Scars causes were burn and scald in 25 cases with a disease duration of 6 months to 7 years (mean, 4.5 years). The hypertrophic scars located at face in 15 cases, and at upper limb and hand in 10 cases. The soft tissue expanders (300-500 mL in volume) were implanted in the delto-pectoral zone and abdominal region in one-stage operation. In two-stage operation, after scars were resected, defects (9 cm × 7 cm to 17 cm × 8 cm) were repaired with the delto-pectoralperforator flaps (17 cm × 7 cm to 20 cm × 8 cm) in 15 facial scar cases and with the deep inferior epigastric artery perforator flaps (10 cm × 9 cm to 25 cm × 14 cm) in 10 upper limb and hand scar cases. The donor sites were sutured directly. Results Partial necrosis of the flaps occurred in 2 cases after operation, then the flap survived after expectant treatment. The other flaps and skin grafts survived successfully, and the incisions healed by first intention. Ten patients were followed up 6 months to 4 years. Theappearance, texture, and color of the flaps were similar to those at the donor site. Conclusion It is an effective method to use the delto-pectoral perforator flap and the deep inferior epigastric artery perforator flap for repairing soft tissue defects of the face and upper limb after scar excision.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 膝上外侧动脉穿支髂胫束皮瓣修复腘窝软组织缺损

    目的 总结膝上外侧动脉穿支髂胫束皮瓣修复腘窝软组织缺损的疗效。 方法2009年1月-2011年8月,收治9例腘窝软组织缺损患者。男5例,女4例;年龄24~53岁,平均35.2岁。交通事故伤5例,热压伤2例,绞伤2例。新鲜创面3例,陈旧创面6例;伤后距皮瓣修复术8~24 d。软组织缺损范围5 cm × 3 cm~15 cm × 8 cm。采用大小为7 cm × 4 cm~20 cm × 8 cm的膝上外侧动脉穿支髂胫束皮瓣移位修复创面。供区直接缝合或游离植皮修复。 结果术后3例皮瓣远端坏死,对症处理后成活;其余皮瓣及供区植皮均顺利成活,创面Ⅰ期愈合。9例均获随访,随访时间8个月~2年3个月,平均1年7个月。腘窝外形良好,膝关节屈曲120~140°,伸直—5~0°。结论膝上外侧动脉穿支髂胫束皮瓣位置隐蔽,无需显露膝上外侧血管蒂,皮肤较薄,血供可靠,可切取面积较大,适用于腘窝软组织缺损的修复。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 游离双侧双叶骨间背动脉穿支皮瓣修复四指掌侧皮肤缺损一例

    目的 总结1例应用游离双侧双叶骨间背动脉穿支皮瓣修复4指掌侧皮肤缺损的方法及疗效。 方法2011年10月收治1例35岁左手机器绞伤男性患者,清创后示、中、环、小指掌侧皮肤软组织缺损范围为5.0 cm × 2.5 cm~10.0 cm × 3.0 cm,采用大小为6.0 cm × 3.0 cm~10.0 cm × 3.5 cm的游离双侧双叶骨间背动脉穿支皮瓣修复创面。供区游离植皮修复。 结果术后皮瓣及植皮均成活,创面Ⅰ期愈合。患者获随访7个月,皮瓣外形、质地良好。末次随访时示、中、环、小指关节主动活动度分别为210、90、90、70°。 结论游离双侧双叶骨间背动脉穿支皮瓣修复4指掌侧皮肤软组织缺损可获得较好近期疗效。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 大鱼际微型穿支皮瓣在拇指近节指腹挛缩修复中的应用

    目的 总结大鱼际微型穿支皮瓣修复拇指近节指腹挛缩的方法及疗效。 方法2010年8月-2011年9月,收治拇指近节指腹挛缩患者9例。男6例,女3例;年龄17~60岁,平均45岁。致伤原因:再植术后挛缩 4例,机器绞伤3例,压砸伤2例。瘢痕挛缩3个月~2年。先行挛缩指腹开大,开大后指腹缺损范围为8 mm × 2 mm~30 mm × 15 mm;然后采用大小为25 mm × 10 mm~35 mm × 15 mm的大鱼际微型穿支皮瓣移位修复缺损。供区直接缝合。 结果术后皮瓣完全成活,创面Ⅰ期愈合;供区切口Ⅰ期愈合。患者均获随访,随访时间6~12个月,平均9个月。皮瓣外形良好,质地柔软。拇指背伸80~90°及外展90°。瘢痕无复发;大鱼际切口无瘢痕挛缩,拇指关节活动正常。末次随访时手功能按中华医学会手外科学会上肢部分功能评定试用标准评定,获优8指,良1指。 结论大鱼际微型穿支皮瓣具有不损伤主干动脉的优点,是修复拇指近节指腹挛缩的理想方法之一。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
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