应用双侧耳廓复合组织修复鼻翼缺损

探讨应用双侧耳廓复合组织修复较大鼻翼缺损的可行性及手术方法。沿鼻翼缺损的上方瘢痕缘作弧形切口,设计鼻翼内侧面衬里,于两侧耳廓中上部切取楔形全层复合组织瓣游离移植于受区,以修复缺损外侧面。结果：临床应用双侧耳廓复合修复较大鼻翼缺损６例,均取得了满意的效果,结论：这种手术方法是可行的;并为修复较大鼻翼缺损提供了简便,安全,可靠的方法。     

耳廓复合组织游离移植在鼻翼缺损修复中的应用

目的　修复鼻翼缺损。方法　采用全层或部分耳廓复合组织游离移植的方法修复鼻翼缺损 2 0例 ,其中以鼻翼残存瘢痕组织翻转作衬里 ,然后进行部分耳廓复合组织游离移植 14例 ,移植物面积最小 1.0cm× 1.5cm ,最大1.9cm× 2 .5cm ;利用耳廓复合组织全层嵌入游离移植修复鼻翼缺损者 6例 ,移植物面积最小 0 .5cm× 0 .5cm ,最大0 .8cm× 1.2cm。结果　 2 0例移植组织全部成活。色泽呈暗红至淡红不等 ,无水泡。随访半年移植物色泽与鼻组织基本近似 ,供区隐蔽。结论　在诸多鼻翼缺损修复方法中 ,该方法简便易行、术后鼻翼外形好 ,面部显著部位不增加新的瘢痕 ,有独到优越性     

耳廓复合组织游离移植在鼻翼缺损修复中的应用

目的修复鼻翼缺损.方法采用全层或部分耳廓复合组织游离移植的方法修复鼻翼缺损20例,其中以鼻翼残存瘢痕组织翻转作衬里,然后进行部分耳廓复合组织游离移植14例,移植物面积最小1.0cm×1.5cm,最大1.9cm×2.5cm;利用耳廓复合组织全层嵌入游离移植修复鼻翼缺损者6例,移植物面积最小0.5cm×0.5cm,最大0.8cm×1.2cm.结果 20例移植组织全部成活.色泽呈暗红至淡红不等,无水泡.随访半年移植物色泽与鼻组织基本近似,供区隐蔽.结论在诸多鼻翼缺损修复方法中,该方法简便易行、术后鼻翼外形好,面部显著部位不增加新的瘢痕,有独到优越性.     

耳廓复合组织移植修补鼻翼缺损

目的：总结耳廓复合组织移植修复鼻翼缺损的方法和经验,特别是术中和术后的处理要点。方法：将包括软骨在内的耳廓复合组织游离移植用于修复鼻翼缺损。结果：本组42例均取得较好效果。修复的鼻翼弧度自然、形态满意。本文对术中和术后的处理要点和经验进行了讨论、总结。结论：耳廓复合组织游离移植修复鼻翼缺损的方法简单易行、成功率高,有较好的临床应用与推广价值。     

运用耳廓复合组织瓣修复鼻翼缺损

1997年以来，我科应用耳廓复合组织瓣游离移植修复鼻翼缺损8例，均获成功，报道如下。     

耳廓复合组织瓣在鼻翼部分缺损修复中的应用

目的 探讨耳廓复合组织瓣修复鼻翼单、双侧较大面积缺损的可行性。方法:在8例病例中,采用宽度为1.5～2.2cm耳廓复合组织瓣游离移植的方法修复较大面积的鼻翼缺损,其中3例为双侧缺损。结果:应用此法行鼻冀单、双侧缺损的修复,手术效果满意。结论:在鼻翼缺损修复中,将游离耳廓复合组织瓣宽度由常规小于1cm扩大至1.5～2.2cm是可能的,且可同时应用双侧组织瓣修复双侧鼻翼缺损,故对于鼻翼较大面积单、双侧缺损,此手术方式不失为一种较理想的修复方法,值得推广。     

耳廓复合组织瓣游离移植修复鼻翼缺损25例体会

鼻翼缺损是整形外科常见缺损,修复鼻翼缺损的手术方法较多,自1999年9月至2004年3月,我们应用耳廓复合组织瓣游离移植的方法修复鼻翼缺损25例,术后鼻外形满意。临床资料1.一般资料:本组25例,其中男14例,女11例;年龄17~49岁,平均26.7岁。烧伤后鼻翼缺损5例,创伤致鼻翼缺损8例,动物咬伤所致鼻翼缺损11例,肿瘤切除后鼻翼缺损1例。本组患者均为单侧鼻翼缺损。病程最短者为肿瘤切除后即时修复,病程最长为幼年被鼠咬伤后18年,平均3.9年。移植耳廓复合组织瓣面积0.7cm×0.9cm~1.9cm×2.2cm,平均1.1cm×1.3cm。2.手术方法:①术前准备:常规术前检查,鼻…     

耳郭复合组织瓣修复鼻底部分缺损

目的　灵活运用耳郭复合软骨组织瓣修复鼻底部分缺损畸形。方法　采用耳郭中上部复合软骨组织修复鼻翼缺损 ,下部修复鼻小柱缺损 ,耳垂缘皮肤脂肪复合组织修复鼻尖缺损。结果　随访患者 6个月至 3年 ,除 1例患者鼻翼缺损 ,因加压不彻底 ,复合组织块外侧缘有 1.0mm× 1.5mm坏死外 ,其余复合组织瓣均成活。结论　在牢固掌握血供原则下 ,手术方法简单 ,外形效果较好 ,是该部位修复的首选方法     

利用耳廓复合组织片移植治疗环缩耳畸形

目的　用简单有效的方法治疗先天性单侧环缩耳畸形。方法　利用正常侧耳廓复合组织片移植于对侧畸形的环缩耳 (Ⅱ型 12例 ,Ⅰ型 3例 ) ,以此延长耳轮、显露耳舟及三角窝 ,从而矫正畸形。结果　 15例患者的耳廓复合组织片全部成活 ,耳轮延长 ,耳舟显露 ,从而使双耳基本对称。结论　本手术矫正环缩耳简单易行 ,效果满意。     

耳廓复合组织游离移植矫治中度杯状耳畸形

目的:探讨采用健侧耳廓复合组织游离移植矫治中度先天性杯状耳畸形的新术式。方法:采用健侧耳廓复合组织游离移植,治疗中度杯状耳畸形患者48例,共48只畸形耳。结果:48例患者的复合组织全部成活,耳轮延长,耳舟显露,整个外耳形态满意,双侧基本对称。结论:采用健侧耳廓复合组织游离移植矫治中度先天性杯状耳畸形的手术方法简单易行,基本纠正了杯状耳的全部解剖缺陷。     

扩大的耳廓组织瓣游离移植修复鼻基底细胞癌术后缺损

目的:探讨应用扩大的耳廓复合组织瓣修复鼻部基底细胞癌扩大切除术后缺损创面的手术方法及适应证。方法:根据患者病理确诊后实施鼻部基底细胞癌扩大切除术,依据缺损范围,采用单侧或双侧扩大耳廓复合组织瓣游离移植进行修复。术中彻底切除癌组织,病理证实切缘(-),将耳廓复合组织瓣游离,楔形植入鼻部缺损区,适度加压包扎固定,术后2周拆线。结果:本组18例患者,均移植成功,外形满意。修复创面面积约2.0~2.5cm,随访患者3~6个月,移植初期创面组织高出鼻部周缘,后期均发生不同程度回缩,与周缘组织融合自然,外形基本满意。结论:通过病理学证实肿物性质,确保周缘阴性,形成扩大创面,选用扩大耳廓复合组织瓣游离移植修复,通过对移植组织块精细缝合和适度加压固定技术,使创面得以修复,外形自然,供区隐蔽。本术式是较理想修复鼻部较大创面的术式选择。     

双侧鼻前庭切口入路鼻尖低平鼻翼宽大整复术

临床上常见因先天性鼻翼软骨形态异常而产生的鼻尖低平、鼻翼宽大畸形，单纯用隆鼻术很难矫正。采用鼻尖部蝶形切口入路整复，在鼻外露部位留有手术瘢痕。１９９２年５月以来，我们采用双侧鼻前庭切口入路，两侧鼻翼软骨靠拉拢缝合的方法，以达到鼻尖低平鼻翼宽大整复的目的。临床施术２６１例，经４个月至４年随访，疗效满意。该手术具有安全可靠、操作便易、整复确切、并发症少、体表外露部位无瘢痕等优点。     

The use of a biodegradable collagen/vicryl composite membrane to repair partial nephrectomy in rabbits

Summary A composite membrane produced from collagen and vicryl mesh has been used to cover the kidney surface following partial nephrectomy in rabbits. The membrane readily held sutures, gave satisfactory haemostasis, and prevented leakage of urine. The experiments showed that the prosthesis biodegraded in less than twenty weeks. The only observed long-term effect of the material was thickening of the renal capsule. The results indicate that this membrane may be a suitable reparative materal for use in traumatised kidneys in humans.     

改进的耳后乳突区皮瓣修复耳垂缺损

目的：探讨改进的耳后乳突区皮瓣再造耳垂的新方法及效果。方法：将耳后乳突区的双叶形皮瓣设计成圆锥形皮瓣再造耳垂。结果：用改进的耳后乳突区皮瓣折叠法再造耳垂6例，全部一期手术完成，再造耳垂外形自然流畅，供区瘢痕隐蔽。结论：改进的耳后乳突区皮瓣折叠法再造耳垂，手术创伤小、瘢痕隐蔽、再造耳垂外形自然，是一种值得推广应用的耳垂再造方法。     

Successful surgical repair of a ventricular septal defect and high take-off of the right coronary artery in an infant

A 6-month-old boy was admitted in acute distress because of severe dyspnea and intractable congestive heart failure. With a diagnosis of the ventricular septal defect, pulmonary hypertension and deteriorated lung function due to the respiratory syncytial virus infection, he was taken to the operating room to undergo banding of the pulmonary artery. However, an intraoperative finding of the anomalous high take-off from the right coronary artery made us to discontinue the banding procedure. After intensive medical management, he underwent a successful surgical repair of the defect with no ischemic injury to the myocardium. Congenital cardiac defects having this particular subset of anomalies of the coronary artery need to be repaired primarily since the palliative procedure near the anomalous coronary artery has a potential hazard to compromise the flow of blood through this artery.     

带掌长肌腱的静脉皮瓣修复伸肌腱Ⅰ区复合组织缺损

目的:介绍应用带掌长肌腱的静脉皮瓣修复伸肌腱Ⅰ区复合组织缺损的治疗方法。方法:对11例11指中末节指背皮肤及伸肌腱缺损采用同侧前臂静脉皮瓣带掌长肌腱修复,并予以伸肌腱止点重建。结果:11例皮瓣成活,伤口Ⅰ期愈合。皮瓣供区直接缝合,术后随访4～26月,平均8月,手指外形及功能恢复良好。结论:应用静脉皮瓣带掌长肌腱修复伸肌腱Ⅰ区指背皮肤软组织及伸肌腱缺损,同时行伸肌腱止点重建,是Ⅰ期修复指背皮肤软组织及伸肌腱同时缺损的理想方法。     

Establishment of a bilateral femoral large segmental bone defect mouse model potentially applicable to basic research in bone tissue engineering

Background

To understand the cellular mechanism underlying bone defect healing in the context of tissue engineering, a reliable, reproducible, and standardized load-bearing large segmental bone defect model in small animals is indispensable. The aim of this study was to establish and evaluate a bilateral femoral defect model in mice.

Materials and methods

Donor mouse bone marrow mesenchymal stem cells (mBMSCs) were obtained from six mice (FVB/N) and incorporated into partially demineralized bone matrix scaffolds to construct tissue-engineered bones. In total, 36 GFP⁺ mice were used for modeling. Titanium fixation plates with locking steel wires were attached to the femurs for stabilization, and 2-mm–long segmental bone defects were created in the bilateral femoral midshafts. The defects in the left and right femurs were transplanted with tissue-engineered bones and control scaffolds, respectively. The healing process was monitored by x-ray radiography, microcomputed tomography, and histology. The capacity of the transplanted mBMSCs to recruit host CD31⁺ cells was investigated by immunofluorescence and real-time polymerase chain reaction.

Results

Postoperatively, no complication was observed, except that two mice died of unknown causes. Stable fixation of femurs and implants with full load bearing was achieved in all animals. The process of bone defect repair was significantly accelerated due to the introduction of mBMSCs. Moreover, the transplanted mBMSCs attracted more host CD31⁺ endothelial progenitors into the grafts.

Conclusions

The present study established a feasible, reproducible, and clinically relevant bilateral femoral large segmental bone defect mouse model. This model is potentially suitable for basic research in the field of bone tissue engineering.