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find Keyword "股前外侧皮瓣" 44 results
  • 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
  • ANTEROLATERAL THIGH AND GROIN CONJOINED FLAP FOR EMERGENT REPAIR OF ULTRA-LONG COMPLEX TISSUE DEFECTS IN FOREARM AND HAND

    Objective To evaluate the effectiveness of anterolateral thigh and groin conjoined flap in emergent repair of ultra-long complex tissue defects in forearm and hand. Methods Between February 2009 and October 2011, 6 patients with complex tissue defect of dorsal forearm and hand were in adminsion. There were 5 male and 1 female with an average age of 38.5 years (range, 32-47 years). Injury reasons included machine injury in 5 cases and traffic accident injury in 1 case. Injury to admission time was from 3 to 16 hours (mean, 6 hours). All case were single limb injury, including right forearm and hand injury in 4 cases and left forearm and hand injury in 2 cases. The wound area was from 36 cm × 9 cm to 48 cm × 12 cm. The type of associated injury included elbow dislocation associated with open injury in 2 cases; fractures of the radial, ulnar, and metacarpal bone in 4 cases; defects of wrist dorsal skin and extensor tendons of fingers and wrist in 5 cases; and defects of ulnar artery and ulnar nerve in 1 case. The anterolateral thigh and groin conjoined free flaps were used to repair defects in the forearm and hand in emergency. The area of flap was from 36 cm × 9 cm to 48 cm × 12 cm. Meanwhile the partial functional reconstruction was performed. The donor site was repaired by skin grafts. Results The anastomotic embolization of vascular pedicle and arteria interossea dorsalis occurred in 1 case, purulent secretion under the flap in 1 case, which were cured after symptomatic treatment; the skin flaps completely survived, and primary healing of the wounds were obtained in the other cases. The donor skin grafts survived in 2 cases, and partial necrosis of the skin graft of lower abdominal occurred in 4 cases, and healed after changing dressing. All of the 6 patients were followed up 3 to 18 months (mean, 10 months). The appearance and texture of the flaps were good. The protective sensation was recovered in 2 cases followed up for more than 14 months; no sensory recovery was observed in the other cases. At last follow-up, according to the upper extremity functional evaluation standard by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 1 case, good in 4 cases, and poor in 1 case, and the excellent and good rate was 83.3%. Conclusion It could get a good short-term effectiveness to use the anterolateral thigh and groin conjoined flap for emergent repair of the ultra-long and complex tissue defects in forearm and hand.

    Release date:2016-08-31 04:08 Export PDF Favorites Scan
  • REVERSE ANTEROLATERAL THIGH FLAP FOR REPAIR OF WOUND DEFECTS WITH EXPOSED TIBIA

    【Abstract】 Objective To investigate the method and effectiveness of reverse anterolateral thigh flap and muscle flap for repair of wound defects with exposed tibia in the proximal-middle leg. Methods Between October 2005 and April 2010, 16 patients with wound defects with exposed tibia in the proximal-middle leg were treated with reverse anterolateral thigh flap and muscle flap. There were 10 males and 6 females, aged from 16 to 52 years. Injury was caused by traffic accident in 11 cases and by crushing in 5 cases. The disease duration of 1-6 hours (mean, 3 hours) in 10 patients and 6-14 days (mean, 10 days) in 6 patients, who underwent tibial fracture plate fixation in other hospitals. The size of wound ranged from 13 cm × 7 cm to 20 cm × 13 cm. The size of the flap ranged from 16 cm × 10 cm to 23 cm × 15 cm. The donor sites were covered with splite thickness skin grafts. Results Infection occurred in 2 flaps at 5-7 days and was cured after 1 week of dressing change; the other flaps survived and the wounds healed by first intention. The incisions healed well and the skin grafts survived at the donor sites. All cases were followed up 10-23 months (mean, 18 months). The appearance of the flap was slightly overstaffed, but the color and texture were satisfactory. All fractures healed at 8-10 months after operation. Conclusion It is effective to repair wound defects with exposed tibia in the proximal-middle leg with reverse anterolateral thigh flap and muscle flap.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 封闭式负压引流联合游离股前外侧皮瓣修复Pilon骨折术后软组织缺损

    目的 总结封闭式负压引流(vacuum sealing drainage,VSD)联合游离股前外侧皮瓣移植修复Pilon骨折术后软组织缺损的疗效。 方法2008年3月-2011年7月,收治Pilon骨折术后软组织缺损患者23例。男15例,女8例;年龄16~63岁,平均32.2岁。Pilon骨折术后至此次手术时间为1~6个月,平均3.2个月。创面伴骨、钢板螺钉外露,创面范围9 cm × 5 cm~13 cm × 7 cm。VSD治疗后,切取大小为10 cm × 6 cm~15 cm × 9 cm的游离股前外侧皮瓣移植修复创面。供区直接缝合(6例)或游离植皮(17例)修复。 结果术后3例皮瓣发生静脉危象,其余皮瓣均顺利成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合,皮片除1例出现边缘部分坏死外,其余均成活。23例均获随访,随访时间6~24个月,平均11.5个月。皮瓣质地柔软,外形、色泽好。术后6个月踝关节功能按照美国矫形足踝协会(AOFAS)评分系统评定:获优11例,良8例,可3例,差1例;优良率为82.6%。 结论应用VSD联合游离股前外侧皮瓣修复Pilon骨折术后软组织缺损,可缩短治疗周期,提高手术成功率,最大限度恢复肢体功能。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 股前外侧皮瓣游离移植修复足踝部大面积皮肤软组织缺损

    目的 总结股前外侧皮瓣修复足踝部大面积皮肤软组织缺损的临床应用效果。 方法 2007 年1 月-2010 年12 月,采用股前外侧皮瓣修复30 例足踝部大面积皮肤软组织缺损。男18 例,女12 例;年龄18 ~ 55 岁,平均36 岁。外伤19 例,烧伤4 例,慢性感染创面7 例。病程9 h ~ 8 个月。缺损部位:小腿下1/3 及跟腱区8 例,外踝及足背外侧区10 例,内踝及足背内侧区5 例,足跟及足底7 例。创面均伴血管、骨及肌腱外露。创面缺损范围20 cm × 14 cm ~ 23 cm ×21 cm。皮瓣切取范围为22 cm × 16 cm ~ 25 cm × 23 cm。供区游离植皮修复。 结果 术后5 ~ 7 d 3 例皮瓣边缘出现部分坏死,予以加强换药后成活;其余皮瓣及供区植皮均顺利成活,创面均Ⅰ期愈合。患者均获随访,随访时间6 ~ 36 个月,平均18 个月。皮瓣耐磨,无局部溃烂,其中27 例恢复保护性感觉。但皮瓣外形臃肿,12 例于术后1 年行二次手术皮瓣修整后,外形满意。 结论 股前外侧皮瓣具有切取范围大、血管口径粗、部位隐蔽等特点,是修复足踝部大面积皮肤软组织缺损的有效方法之一。

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • ANTEROLATERAL THIGH FLAP FOR REPAIR OF TOE EXTENSOR TENDON AND DORSAL FOOT WOUND

    Objective To summarize the method and the cl inical outcome of repairing both toe extensor tendon and dorsal foot wounds with anterolateral thigh flap. Methods Between February 2007 and May 2009, 11 patients with toe extensor tendon and dorsal foot defect were treated with anterolateral thigh flap. There were 8 males and 3 females with a medianage of 45 years (range, 10-60 years). The causes of injury were sharp injury in 3 cases, machine crush injury in 3 cases, and traffic accident injury in 5 cases, including 7 cases of fresh wounds with a disease duration of 2-8 hours and 4 cases of old wounds with a disease duration of 3-15 days. The size of wound ranged from 6 cm × 5 cm to 25 cm × 15 cm. All cases compl icated by toe extensor tendon defect, which were located at the 2nd-5th toes in 1 case, 3rd-5th toes in 1 case, 2nd-4th toes in 2 cases, 2nd and 3rd toes in 3 cases, 1st and 2nd toes in 1 case, and 1st toe in 3 cases. In the first stage, the anterolateral thigh flap ranged from 8 cm × 7 cm to 27 cm × 15 cm was used to repair defect and fascia lata was used to bridge two ends of digitorum longus tendon; the donor site was sutured or repaired with the skin graft. The second stage was performed after 2-3 months, tenolysis for tendon was performed, and fascia lata was spl it into tendon-l ike shape; and the toe functional exercises were done. Results All flaps survived completely after the first stage, wounds healed by first intention; the donor skin graft survived and incisions healed by first intention. At 7 days after the second stage, marginal necrosis occurred in 3 flaps (0.5-2.0 cm in width), and healed after 15-20 days of dressing change; the other flaps survived, and incisions healed by first intention. Eight patients were followed up 12-18 months (mean, 15 months). Excepts 4 sl ight bulky flaps, the other flaps had satisfactory appearance and soft texture with two points discrimination of 1-3 cm. During the follow-up, part of the dorsiflexion function recovered in 5 patients (5-40°), andflexion function was normal; 3 dorsiflexion function disappeared without effect on the function of toe flexion, and the patients could walk normally. No toe ptosis occurred. Conclusion Appl ication of the anterolateral thigh flap can repair toe extensor tendon and dorsal foot wounds with short treatment time and less damage at the donor site, so it can avoid toe ptosis after surgery and achieve excellent cl inical results.

    Release date:2016-08-31 05:43 Export PDF Favorites Scan
  • 两种皮瓣一期修复头皮鳞状细胞癌术后缺损疗效分析

    目的 总结不同皮瓣一期修复头皮鳞状细胞癌术后缺损疗效。 方法 回顾分析1997年1月-2011年3月收治的44例头皮鳞状细胞癌患者临床资料。男32例,女12例;年龄36~65岁,平均45.2岁。病程1个月~2 年。病变部位:额部7例,顶部27例,颞部8例,枕部2例。高分化鳞状细胞癌38例,低分化鳞状细胞癌6例。肿瘤切除后头皮缺损范围为5 cm × 4 cm~27 cm × 11 cm。33例缺损lt;10 cm × 8 cm者采用大小为6 cm × 5 cm~10 cm × 8 cm的邻近头皮瓣移位修复,11例缺损gt; 10 cm × 8 cm者采用大小为11 cm × 9 cm~28 cm × 12 cm吻合血管的游离股前外侧皮瓣修复。供区采用游离植皮修复。术后正规放、化疗。 结果 术后2例皮瓣发生远端坏死,经换药后成活;其余皮瓣及供区植皮均成活,切口Ⅰ期愈合。放疗后皮瓣存活良好。30例患者获随访,随访时间2~3年,平均2.5年。皮瓣质地、颜色与周围正常皮肤相似,无局部臃肿。术后平均1.2年5例低分化鳞状细胞癌患者复发,其余患者肿瘤无复发,存活良好。 结论 根据缺损大小选择合适的皮瓣一期修复头皮鳞状细胞癌切除后缺损,均可获得较好疗效。

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • 股前外侧皮瓣重建咽喉食管一例近期疗效

    目的 总结1 例股前外侧皮瓣重建颈段食管的方法及效果。 方法 2007 年9 月,收治1 例42 岁下咽癌男性患者(T4N3M0)。病程4 个月。患者声音嘶哑,吞咽困难。2003 年曾行食管癌(中下段)根治术,胃代食管,食管胃颈部吻合术。行肿瘤切除术后采用大小为10 cm × 7 cm 的股前外侧皮瓣重建咽喉食管。 结果 术后股前外侧皮瓣成活,无血肿及感染等并发症发生。供区Ⅰ期愈合。患者术后2 周进食通畅,无咽漏。术后1 个月,吞钡X 线检查,再造食管无狭窄和食管吻合口漏发生。患者获随访6 个月,进食良好,皮瓣无坏死,肿瘤无复发。 结论 股前外侧皮瓣重建咽喉食管是一种安全、有效的手术方法,并发症少。

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • ANALYSIS OF THE DONOR-SITE COMPLICATIONS OF THE ANTEROLATERAL THIGH FLAP

    Objective To investigate the donor-site compl ications of the anterolateral thigh flap and its influencing factors. Methods Between July 1988 and July 2007, 427 patients were treated with anterolateral thigh flap. Among them, 33 patients had postoperative donor-site compl ications and their cl inical data were analyzed retrospectively. There were 21 malesand 12 females aged 14-47 years old (average 32.7 years old). The size of the wound defect ranged from 16 cm × 7 cm to 28 cm × 13 cm. The area of the flap harvested during operation ranged from 16 cm × 7 cm to 30 cm × 13 cm. The donor sites were treated by direct suture in 7 cases; free spl it-thickness skin graft in 23 cases, and reverse superficial epigastric artery flap repair in 3 cases. The size of graft in the donor site ranged from 10 cm × 5 cm to 18 cm × 8 cm. The occurrence of short-term (within 4 weeks) and long-term (over 6 months) compl ications were analyzed. Results All patients were followed up for 8-54 months (average 21 months). There were 26 patients (78.8%) with short-term and long-term compl ications and 7 patients (21.2%) with long-term compl ications. The short-term compl ications included skin graft necrosis in 23 cases (69.7%), wound infection in 17 cases (51.5%), and muscle necrosis in 2 cases (6.1%). The long-term compl ications included non-heal ing wounds in 21 cases (63.6%), serious scar in 28 cases (84.8%), discomfort in 25 cases (75.8%), and dysfunction of the quadriceps femoris in 16 cases (48.5%). Conclusion The occurrence of anterolateral thigh flap donor-site compl ications is related to the anatomical structure of the anterolateral thigh region, the surgical procedure, and the patient’s physique.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 股前外侧皮瓣加髂骨植骨修复手背软组织及掌骨缺损二例

    2006 年5 月,我科收治2 例因严重外伤造成手背部较大软组织及掌骨缺损患者,采用股前外侧皮瓣联合髂骨移植的方法予以修复,操作较简便,效果良好。报告如下……

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