羟基磷灰石义眼台巩膜瓣后置入术美容效果分析

目的探讨羟基磷灰石义眼台巩膜瓣后置入术的美容效果。方法眼内容物剜除的患者，采用巩膜后羟基磷灰石义眼台置入术治疗。结果共治疗32例，其中眼球萎缩14例、角巩膜葡萄肿5例、绝对期青光眼3例、新生血管性青光眼3例、眼球破裂伤7例。随访3～12个月，未发现义眼台脱出、移位，置入物性能稳定、可靠，眼睑饱满，义眼活动度良好，美容效果满意。结论羟基磷灰石义眼台巩膜瓣后置入术可达到良好美容效果。     

上睑眼轮匝肌肌皮瓣在修复瘢痕性下睑外翻中的应用

目的：探讨应用上睑眼轮匝肌肌皮瓣修复轻中度下睑外翻的方法。方法：在完成上睑皮肤松弛矫正的同时，将上睑睑板表面剥离并形成上睑眼轮匝肌肌皮瓣，转移至下睑外翻患处，2周后断蒂，上睑形成重睑。结果：17例患者实施该手术后上睑形态流畅，下睑外翻基本矫正，外观满意，随访3～6个月，无下睑外翻复发。结论：应用上睑眼轮匝肌肌皮瓣修复轻重度下睑外翻是一种较为可行的手术方法。     

瘢痕内切除瘢痕瓣回植联合药物注射治疗瘢痕疙瘩

目的:分析手术切除联合药物注射治疗瘢痕疙瘩的疗效。方法:瘢痕部分切除瘢痕瓣回植联合药物扩大注射一个疗程。结果:57块瘢痕疙瘩治愈47块,显效8块。结论:瘢痕内切除瘢痕瓣回植结合药物扩大注射治疗瘢痕疙瘩效果满意。     

Postmastectomy reconstruction with extended latissimus dorsi myocutaneous flap for Hong Kong Chinese

Objective: Because of the smaller breast size of Chinese women, postmastectomy reconstruction without prosthesis by extended latissimus dorsi (LD) flap is potentially more applicable in the Chinese population. Methods: Patients who had undergone immediate postmastectomy breast reconstruction by extended latissimus dorsi flap without prosthesis were retrospectively studied. Surgical complications, aesthetic result and patient satisfaction were evaluated. Results: Ten Asian patients (nine Chinese and one Filipino) underwent extended LD flap for breast reconstruction after mastectomy. There was no total or partial flap failure. Operative complications included seroma in one patient and minor wound edge slough at back wounds in two patients. Simultaneous seroma and minor donor wound slough occurred in another patient. Aesthetic outcome was excellent (n = 5), good (n = 4) and poor (n = 1). Patient satisfaction with the procedure was very satisfied in four, satisfied in four and dissatisfied in two, respectively. All but two patients would recommend the same procedure to their friends or relatives. Conclusion: Extended LD flap can reliably achieve pleasing results with low morbidity. It has more potential to become a competitive alternative to transverse abdominis myocutaneous flap in most Chinese women for postmastectomy reconstruction.     

局部皮瓣在头面部皮肤肿瘤及皮肤病切除修复中的应用

目的 探讨头面部皮肤肿瘤及皮肤病术后缺损的多种局部皮瓣修复方法及效果.方法 根据病灶的部位、大小、形态及邻近皮肤情况,分别选择应用"风筝"皮下蒂皮瓣、双叶皮瓣、鼻唇沟皮瓣、眼轮匝肌蒂皮瓣、A-T皮瓣、双侧舌形皮瓣等方法修复创面.结果 76例术后皮瓣全部I期成活,随访50例2个月至3年,1例基底细胞癌于术后1年复发,行扩大切除后,其余均无复发,头面部的轮廓、形态及功能均满意.结论 应用局部皮瓣修复头面部较大范围的肿瘤或皮肤病术后缺损,是能获得功能与形态的双重良好效果的方法.     

鼻唇沟随意皮瓣修复鼻翼部分缺损

目的:介绍鼻唇沟随意皮瓣修复鼻翼部分缺损的手术方法.方法:在鼻翼缺损一侧的鼻唇沟区设计一个蒂在上方的随意皮瓣,手术分三期完成.自2000年起,采用该方法修复单侧鼻翼缺损5例,缺损的面积最小1.0cm×0.6cm,最大1.2cm×1.0cm.结果:移植的皮瓣均成活,其色泽与邻近部位的皮肤近似,外形满意,供区无遗留明显畸形.结论:鼻唇沟随意皮瓣修复鼻翼部分缺损能获得较满意的结果.     

皮瓣移植在我国烧伤外科中的应用

The history and application of surgical flap transplantation in burn wound were briefly reviewed. We outlined skin flap, muscuiocutaneous flap, fascia flap and neurocutaneous vascular flap in this paper and recommended repair deep wounds with flap. All in all, in this review, we hope to provide a meaningful option for clinical application of surgical flap in the future.     

双叶皮瓣在鼻部皮肤软组织缺损修复中的应用

目的探讨和评价应用双叶皮瓣修复鼻部皮肤软组织缺损的临床效果。方法采用局部浸润麻醉，按病变组织的形状将其行圆形或椭圆形切除，并于缺损部位附近的正常皮肤处设计双叶皮瓣，转移覆盖缺损部位。结果本组22例患者，术后随访3个月至1年，病变组织切除后均完整修复，皮瓣全部成活，切口Ⅰ期愈合，瘢痕不明显，皮瓣色泽与周围皮肤相近，鼻外形较好。结论应用双叶皮瓣修复鼻部皮肤软组织缺损，方法简单、安全。皮瓣转移后张力小、血运丰富，达到美容效果。是修复鼻部缺损较理想的方法。     

Repair of cervical esophageal perforation using longus colli muscle flap: a case report of a patient with cervical spinal cord injury

BACKGROUND CONTEXT: Perforation of the esophagus after anterior cervical spine surgery is a rare, but well-recognized complication. The management of esophageal perforation is controversial, and either nonoperative or operative treatment can be selected. PURPOSE: Several reports have described the use of a sternocleidomastoid muscle flap for esophageal repair. In this case report, we describe a longus colli muscle flap as a substitute for a sternocleidomastoid flap in a patient with an esophageal perforation. STUDY DESIGN: Case report. PATIENT SAMPLE: A 20-year-old man sustained cervical spinal cord injury, on diving and hitting his head against the bottom of a pool. A C6 burst fracture was observed with posterior displacement of a bone fragment into the spinal canal. The patient exhibited complete paralysis below the C8 spinal segment level. METHODS: The patient underwent subtotal corpectomy of the sixth cervical vertebra with the iliac bone graft and augmented posterior spinal fixation (C5-7) with pedicle screws. After the primary operation, the patient showed signs of infection such as throat pain, a high fever, and osteolytic change of the grafted bone by cervical radiograph. A second operation was performed to replace the graft bone using fibula. On the day after the operation, food residue was confirmed in the suction drainage tube, suggesting esophagus perforation. A third operation was immediately performed to confirm and treat esophagus perforation, although apparent esophageal perforation could not be detected at the second operation. Because the erosion around the perforation of the esophageal posterior wall was extensive, a longus colli muscle flap transposition was accordingly performed into the interspace between the esophageal posterior wall and the grafted bone in addition to simple suturing of the perforation. RESULTS: Neither high fever nor pharyngeal pain has recurred at latest follow-up, 5 years after surgery. CONCLUSIONS: To the best of our knowledge, this is the first report concerning the use of a longus colli muscle flap for esophageal perforation after anterior cervical spine surgery.