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find Keyword "软组织缺损" 227 results
  • Reconstruction of ankle and foot with combination of free perforator flaps and skin graft

    Objective To evaluate the clinical outcomes of free perforator flaps combined with skin graft for reconstruction of ankle and foot soft tissue defects. Methods Between June 2014 and October 2015, 20 cases of ankle and foot soft tissue defects were treated. There were 16 males and 4 females, aged from 19 to 61 years (mean, 43.3 years). Injury was caused by traffic accident in 7 cases, by crashing in 9 cases, and machine twist in 4 cases. The locations were the ankle in 6 cases, the heel in 3 cases, the dorsum pedis in 4 cases, and the plantar forefoot in 7 cases of avulsion injury after toes amputation. The size of wound ranged from 15 cm×10 cm to 27 cm×18 cm. The time from injury to treatment was from 11 to 52 days (mean, 27 days). The anterolateral thigh perforator flap was used in 11 cases, thoracodorsal antery perforator flap in 3 cases, medial sural artery perforator flap in 4 cases, deep inferior epigastric perforator flap in 1 case, and anteromedial thigh perforator flap in 1 case, including 5 chimeric perforator flaps, 5 polyfoliate perforator flaps, 3 flow-through perforator flaps, and 3 conjoined perforator flaps. The size of the perforator flap ranged from 10.0 cm×6.5 cm to 36.0 cm×8.0 cm, the size of skin graft from 5 cm×3 cm to 18 cm×12 cm. Results Venous crisis occurred in 2 flaps which survived after symptomatic treatment; 18 flaps survived successfully and skin grafting healed well. The follow-up time ranged 4-18 months (mean, 8.3 months). The flaps had good appearance, texture and color, without infection. The patients could walk normally and do daily activities. Only linear scars were observed at the donor sites. Conclusion Free perforator flap can be used to reconstruct defects in the ankle and foot, especially in the weight-bearing area of the plantar forefoot. A combination of free perforator flap and skin graft is ideal in reconstruction of great soft tissue defects in the ankle and foot.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • REPAIR OF WOUNDS WITH ACHILLES TENDON EXPOSURE

    Objective To investigate the appl ication and cl inical result of flap in the repair of wounds with Achilles tendon exposure. Methods Between May 2006 and May 2010, 21 patients with Achilles tendon skin defects were treated with microsurgical reconstruction. There were 15 males and 6 females, aged 7-63 years with a median of 34 years. The defect causesincluded sport injury in 4 cases, wheel twist injury in 7 cases, crush injury in 5 cases, chronic ulcer in 3 cases, and Achilles tendon lengthening in 2 cases. The areas of wounds with Achilles tendon exposure ranged from 2 cm × 2 cm to 10 cm × 8 cm. After debridement, wounds were repaired with the medial malleolus fasciocutaneous flap (5 cases), sural neurocutaneous vascular flap (8 cases), foot lateral flap (2 cases), foot medial flap (2 cases), and peroneal artery perforator flap (4 cases). The size of the flaps ranged from 3 cm × 3 cm to 12 cm × 10 cm. The donor sites were either sutured directly or covered with intermediate spl it thickness skin grafts. The Achilles tendon rupture was sutured directly (2 cases) or reconstructed by the way of Abraham (2 cases). Results All flaps survived and wounds healed by first intention except 2 flaps with edge necrosis. Twenty-one patients were followed up 6-18 months (mean, 12 months). The flaps had good appearance and texture without abrasion or ulceration. The walking pattern was normal, and the two point discrimination was 10-20 mm with an average of 14 mm. The Ameritan Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale assessment revealed that 10 patients had an excellent result, 7 had a good result, 3 had a fair result, and 1 had a poor result with an excellent and good rate of 81.0%. Fourteen cases could l ift the heels with power; 5 cases could l ift the heels without power sl ightly; and 2 cases could not l ift the heels. Conclusion The wounds with Achilles tendon exposure should be repaired as soon as possible by appropriate flap according to the condition of wound.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • 前臂桡侧逆行岛状皮瓣修复虎口皮肤及软组织缺损一例

    Release date:2016-09-01 09:30 Export PDF Favorites Scan
  • 第二掌骨背侧岛状皮瓣修复拇指掌侧及虎口区皮肤软组织缺损

    目的 总结采用第2 掌骨背侧岛状皮瓣修复拇指掌侧及虎口区皮肤软组织缺损的方法及疗效。 方法 2006 年5 月- 2008 年5 月,采用第2 掌骨背侧岛状皮瓣修复拇指掌侧及虎口区皮肤软组织缺损19 例。男12 例,女7 例;年龄15 ~ 42 岁,平均27 岁。机器压砸伤18 例,虎口区组织挛缩1 例。压砸伤患者中,拇指末节缺损11 例,拇指近节缺损5 例;虎口区皮肤缺损2 例;皮肤软组织缺损范围为2.2 cm 1.0 cm ~ 3.8 cm 2.4 cm。压砸伤患者均为受伤后3 h 内手术,虎口区组织挛缩患者为伤后6 个月手术。术中皮瓣切取范围为2.8 cm 1.2 cm ~ 4.0 cm 2.6 cm,供区采用中厚皮片游离植皮修复。 结果 术后皮瓣及供区皮片均顺利成活,创面Ⅰ期愈合。术后患者均获随访,随访时间6 ~ 24 个月。拇指外形饱满,感觉恢复至S2+;屈伸、外展、对掌、对指功能良好。虎口张开度为80 ~ 85°。 结论 第2 掌骨背侧岛状皮瓣修复拇指掌侧及虎口区皮肤软组织缺损具有手术操作简便、皮瓣质量好、术后皮瓣成活率高等优点,可获得较好疗效。

    Release date:2016-09-01 09:04 Export PDF Favorites Scan
  • 硅胶带修复四肢皮肤软组织缺损16例

    Release date:2016-09-01 09:30 Export PDF Favorites Scan
  • 母趾软组织缺损的修复

    目的 总结 母趾软组织缺损的修复方法及效果。方法 1994年1月~2006年1月,分别采用带蒂皮瓣和游离皮瓣修复母趾软组织缺损128例。其中男79例,女 49例;年龄16~48岁,平均28岁。母趾趾背缺损36例,趾腹缺损29例,脱套伤38例,合并足掌、背缺损25例。创面范围3 cm×2 cm~15 cm×5 cm。病程:急诊手术31例,伤后3 d~1个月77例,1个月以上20例。合并趾骨及跖骨骨折67例,合并骨髓炎11例。应用带蒂皮瓣移位修复105例,范围3 cm×2 cm~7 cm×4 cm;游离皮瓣移植修复23例,范围5 cm×3 cm~15 cm×5 cm。结果带蒂皮瓣均成活,边缘部分坏死6例,换药后愈合;皮瓣质地柔软,外形良好。游离皮瓣23例均成活,皮瓣质地柔软,其中15例外形较臃肿,二期行皮瓣修整。97例获随访6个月~2年,步态正常,均无溃疡发生。结论 选用适宜的皮瓣修复母趾软组织缺损能较好修复创面,最大限度地保留足的行走功能。

    Release date:2016-09-01 09:20 Export PDF Favorites Scan
  • 改良带蒂(足母)展肌肌皮瓣修复足跟部皮肤恶性黑色素瘤术后缺损

    目的 总结采用改良带蒂(足母)展肌肌皮瓣移位修复足跟部皮肤恶性黑色素瘤扩大切除后软组织缺损的疗效。方法 2008年2月-2011年6月,收治5例足跟部皮肤恶性黑色素瘤患者。男2例,女3例;年龄35~69岁,平均49岁。病程2~10年。足跟原发肿瘤范围为3 cm × 2 cm~5 cm × 4 cm,3例伴破溃。4例肿瘤扩大切除后缺损范围为6 cm × 6 cm~8 cm × 6 cm,1例因伴卫星灶缺损达13 cm × 12 cm;采用大小为6 cm × 6 cm~11 cm × 9 cm改良带蒂(足母)展肌肌皮瓣移位修复缺损,不足部分取中厚皮片修复。供区采用腹股沟中厚皮片修复。 结果术后肌皮瓣及供受区植皮均成活,创面Ⅰ期愈合。2例腹股沟切口发生淋巴漏,经换药和清创术后愈合。5例均获随访,随访时间12~24个月。足跟部皮肤无破裂和磨损,外形丰满、弹性良好,肌皮瓣痛、温觉和耐磨性能良好。足踝伸屈功能正常,恢复负重功能,无肿瘤生长。足部切取肌皮瓣处凹陷明显,第1、2、3趾底感觉减退、麻木。 结论改良带蒂(足母)展肌肌皮瓣修复足跟部皮肤恶性黑色素瘤切除后缺损可获得丰满、耐磨和弹性好的外观。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 第一趾蹼皮支蒂岛状皮瓣修复(足母)趾软组织缺损

    目的 总结第1趾蹼皮支蒂岛状皮瓣修复(足母) 趾软组织缺损的疗效。 方法 2009年11月-2011年1 月,收治7例重物砸伤致(足母)趾皮肤软组织缺损男性患者。年龄23~42岁,平均32岁。伤后至入院时间为5~10 d,平均7 d。(足母)趾末节软组织缺损合并末节趾骨外露3例,甲床坏死伴骨外露1例,(足母)趾腓侧皮肤软组织缺损伴骨外露2例,(足母)趾背侧皮肤软组织坏死1例。创面范围3.5 cm × 2.5 cm~4.5 cm × 4.5 cm。应用大小为4.0 cm × 2.5 cm~5.0 cm × 5.0 cm的第1趾蹼皮支蒂岛状皮瓣修复。供区植皮修复。 结果术后皮瓣及植皮均成活,创面Ⅰ期愈合。患者均获随访,随访时间11~20个月,平均14个月。皮瓣质软,外形无臃肿。术后6个月按照神经感觉恢复标准评定,皮瓣感觉S1~S3,植皮区感觉S1~S2。患者第1趾蹼均遗留轻度瘢痕,患足功能良好。 结论第1趾蹼皮支蒂岛状皮瓣修复(足母)趾软组织缺损具有供区创伤小、手术操作简便的优点,适合任何分型的第1跖背动脉。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • LOCAL PLANTAR ROTATORY FLAP FOR REPAIRING OF SOFT TISSUE DEFECT OF HEEL

    OBJECTIVE: Soft tissue defect of heel is not uncommon. Transplantation of free cutaneous flap and transfer of axial cutaneous flap have been used in treating such defect successfully, but both of them are somewhat complicated. Local plantar rotatory flap might show great importance in this field. METHODS: Since March 1993 to March 1998, 9 cases with soft tissue defect of heel were repaired by local plantar rotation flaps. The size of defect ranged from 2 cm x 4 cm to 6 cm x 8 cm, and it was designed superficial to plantar fascia. The flap was medially based, and nutrilized by proximal plantar subcutaneous plexus of blood supply as well as lateral and medial plantar nerve. RESULTS: Followed up 4 months to 2 years, all the flaps were survived. Sensation of the flap was preserved in 7 patients, who had normal sensation of the donated area preoperatively. The transferred flap was endurable to body bearing. CONCLUSIONS: The flap is easily prepared with reliable blood supply and sensation of the flap preserved. The method is worthy to be recommended for widely use because of its advantages over other methods.

    Release date:2016-09-01 11:05 Export PDF Favorites Scan
  • 内踝上皮支皮瓣修复足踝部皮肤软组织缺损

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
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