The application of turn-over flaps to burn wounds

Satisfactory coverage of some deep burn wounds is very difficult. During the past year, 20 de-epithelialized turn-over flaps have been used to cover deep burn wounds in 17 patients. Most of the wounds resulted from electrical injuries which caused exposure of tendons, nerves, bone or joint space. A turn-over flap is a convenient local flap for covering deep burn wounds and reducing morbidity. They adhere well, cause less contracture, and make a good bed for the overlying graft. One disadvantage is that healthy tissue around the wound is not always available; another is questionable tendon gliding. Complications consisted of partial flap necrosis, osteomyelitis and an epithelial cyst. Overall results for the reconstruction of difficult burn wounds were considered exceptionally good.     

八瓣法乳头内陷矫正术

乳头内陷是正常乳头位置发生凹陷。内陷的乳头内部有纤维束牵拉乳头至乳腺组织以及乳腺导管发育不良。多为双侧，也有单侧。既有先天性，也有外伤、手术、肿瘤及乳腺炎后纤维增生引起。本组均为先天性。乳头内陷的矫正既要恢复乳头的形态，又要保留乳头乳晕的感觉及哺乳功能。基于这点，１９９２年至１９９６年为１０例１７侧（７例双侧，３例单侧）先天性乳头内陷者行八瓣法矫正术，效果满意。本文对该手术方法进行了较详细的描述，讨论了先天性乳头内陷的形成原因，临床应用解剖乳头乳晕的血供，术中术后预防乳头再回缩的方法以及介绍了现行矫正乳头内陷的方法。     

A manoeuvre to cover exposed metal using a de-epithelialised "turn-over" fasciocutaneous flap

This paper describes a technical manoeuvre to accommodate an exposed metal implant used in the treatment of a fracture of the tibia within a "turn-over" de-epithelialised fasciocutaneous flap. The need for such a procedure in this particular case is commented upon. A discussion is also included on the nature of the blood supply to the integument based on available information.     

De-epithelialised turn-over flaps for "salvage" operations

Full-thickness loss of a part of a skin flap may produce a serious residual defect that needs additional flap cover. A de-epithelialised "turn-over" skin flap (Thatte, 1981; Mahler and Yanai, 1981; Thatte, 1982) fashioned from the surviving adjacent flap skin, can provide a simple solution to these residual defects. The same technique can also be effectively employed where a skin flap of inadequate dimensions has been transferred to an area resulting in a defect or a deformity due to skin shortage. Two representative cases are presented and the merits of the technique are discussed.     

乳腺三角瓣交叉支撑法矫治乳头内陷

目的介绍一种矫治乳头内陷的新方法。方法采用乳头基底部乳腺组织三角瓣,交叉缝合支撑乳头基底,防止乳头内陷,保持乳头外凸形态。结果应用本方法矫治乳头内陷13例24侧,效果满意。随访2~8个月,乳头功能正常,外形、高度均理想,无回缩。结论本方法简单安全,效果持久,均能获得满意的效果。     

乳腺三角瓣交叉支撑法矫治乳头内陷

目的介绍一种矫治乳头内陷的新方法。方法采用乳头基底部乳腺组织三角瓣,交叉缝合支撑乳头基底,防止乳头内陷,保持乳头外凸形态。结果应用本方法矫治乳头内陷13例24侧,效果满意。随访2-8个月,乳头功能正常,外形、高度均理想,无回缩。结论本方法简单安全,效果持久,均能获得满意的效果。     

The trampoline repair for inverted nipples

Nipple inversion can be a challenging condition to repair. Here we describe a technique of correction of the inverted nipple that is safe, quick and be done easily under local anaesthesia, with little risk on complications like loss of nipple, leaves no significant scarring, and does not burn other bridges that can be used if this technique fails to achieve the desired outcomes. It also does not have the problem of causing a purse string effect around the nipple-arearola complex that some other techniques might cause.     

The use of de-epithelialised cross-finger flaps for dorsal finger defects

A de-epithelialised cross-finger flap procedure for repair of dorsal finger defects is described. It is safe and simple and is considered to have distinct advantages over other available methods of flap repair of the dorsum of the finger. These advantages are discussed.     

Banding of nipples as an augmentation of the suction correction of flat or inverted nipples

Summary Banding the nipples with a split and stretched rubber band or by the use of plaster is supplementary to the suction method for correction of flat or inverted nipples and effectively reduces the number and durations of such suction sessions, substantially improving the results. These procedures are an ideal solution for this condition.     

内陷乳头的持续牵引术

为避免传统手术疗法破坏乳头感觉及哺乳功能，造成瘢痕粘连，乳头回缩，外形不美甚至乳头缺血坏死。以硬泡沫塑料自制牵引架，以竹牙签自制牵引杠，用持续牵引的方法根治乳头内陷。结果：１９８４ 年以来用于６９ 例，１２７ 只轻中重度内陷乳头，持续牵引３ ～６ 个月，随访３ 个月至７ 年，全获成功。结论：持续牵引法根治乳头内陷，方法简单易行，对轻中重度乳头内陷都能治愈，牵出之乳头外形美观，感觉及哺乳功能良好，避免了传统手术疗法的诸多不足。     

S形矫正器牵引治疗乳头内陷的护理体会

目的:探讨一种S形矫正器牵引治疗乳头内陷及其护理方法。方法:术前充分的心理辅导及术区清洁准备,手术在局部浸润麻醉下置入S形矫正器,术后进行伤口护理,指导患者持续接受乳头牵引6个月。结果:应用本方法治疗中重度乳头内陷患者12例,经6个月随访,乳头形态自然稳定,未见复发,效果满意。结论:本方法简便易行,不破坏乳管,不影响哺乳,乳头感觉正常,无明显瘢痕,形态自然稳定,不易复发。     

原发性乳头内陷合并非哺乳期乳腺炎26例诊治

目的探讨原发性乳头内陷并非哺乳期乳腺炎的诊治方法。方法回顾性分析26例原发性乳头内陷并非哺乳期乳腺炎患者的临床资料。结果 26例患者均行手术,18例肿块切除,其中13例内陷乳头矫正,22例患者一次性治愈,4例复发(15.4%),复发者均为未行乳头内陷矫正者。结论原发性乳头内陷合并非哺乳期乳腺炎手术彻底切除病灶并同时行乳头内陷矫正术是彻底有效的治疗方法。     

乳头中央切口及乳晕双"Z"瓣治疗重度乳头内陷

目的介绍一种矫正重度乳头内陷的新方法.方法从重度乳头内陷的病理特点入手,设计出乳头中央切口加乳晕双"Z"瓣.结果乳头内陷矫正除1例早期病例由于松解不充分而复发外,其余14例均获得满意效果,且乳头高度及外形理想.结论该手术方法是矫正重度乳头内陷的一种理想方法.     

乳头中央切口及乳晕双“Z”瓣治疗重度乳头内陷

目的　介绍一种矫正重度乳头内陷的新方法。方法　从重度乳头内陷的病理特点入手 ,设计出乳头中央切口加乳晕双“Z”瓣。结果　乳头内陷矫正除 1例早期病例由于松解不充分而复发外 ,其余 14例均获得满意效果 ,且乳头高度及外形理想。结论　该手术方法是矫正重度乳头内陷的一种理想方法。     

Correction of inverted nipples with the double-track sun-cross running suture technique

Various techniques have been reported for correcting inverted nipples; however, problems such as incomplete correction, recurrence, scarring and nerve or duct injury persist. To minimise the recurrence rate and reliably attain a well-projected nipple, we developed a technique involving a single suture that runs through both the periphery and the core of the nipple. After the dissection and release of fibrotic connective tissue, an absorbable monofilament suture was passed through the periphery and core to leave double tracks of the suture at all locations, creating the final shape of a cross inside a circle (resembling the sun-cross symbol). Finally, the suture was tied in a purse-string manner to push the nipple outward. We performed this surgery on 34 congenital cases, comprising 29 patients with bilateral inverted nipples, 5 patients with a unilateral inverted nipple and 12 patients with an acquired deformity. During a mean follow-up period of 22.4?months, all of the corrected nipples remained everted without reinvagination. We successfully corrected inverted nipples with the double-track sun-cross running suture technique, which provided long-lasting eversion and created an aesthetically pleasing nipple contour.     

乳头基底部挑提法矫治乳头内陷

目的　介绍一种矫治乳头内陷的新方法。方法　采用 12号注射器针头 ,从乳头基底部挑提乳头并持续牵拉固定 ,保持乳头外凸形态。维持 14天后改为 18K金乳环替代。结果　应用本手术方法矫正乳头内陷 11例 ,除 2例失访外 ,其余 9例均获得满意效果 ,且乳头高度、外形及感觉理想。结论　本手术方法简单安全 ,适用范围广 ,效果持久 ,矫治后的乳头形态自然 ,感觉功能正常     

乳头基底部挑提法矫治乳头内陷

目的介绍一种矫治乳头内陷的新方法.方法采用12号注射器针头,从乳头基底部挑提乳头并持续牵拉固定,保持乳头外凸形态.维持14天后改为18K金乳环替代.结果应用本手术方法矫正乳头内陷11例,除2例失访外,其余9例均获得满意效果,且乳头高度、外形及感觉理想.结论本手术方法简单安全,适用范围广,效果持久,矫治后的乳头形态自然,感觉功能正常.     

A simple and effective method for correction of inverted nipples

Inverted nipples cause both functional and aesthetic problems. Functionally, it interferes with lactation and adequate hygiene. Aesthetically, it has an abnormal appearance and leads to psychological disturbance to the patients, hence the importance of correction. Many techniques have been described to correct inverted nipples, but unsatisfactory results, recurrence, multiple, and conspicuous scars all represented unsolved problems. The diversity of corrective techniques indicates the absence of an effective technique with long lasting results. In the current study, a simple and reproducible technique was used for correction of inverted nipples with minimal scarring and durable results. The purpose of this study is to describe the operative technique, the clinical applications and the advantages of this technique, and to compare our work with other authors.