联合应用阴囊纵隔皮瓣及包皮皮瓣一期修复阴囊型尿道下裂

阴囊型尿道下裂由于其尿道开口较上 ,需要一段较长的替代物来修复尿道 ,给手术带来一定困难 ,笔者联合采用阴囊纵隔皮瓣及包皮皮瓣一期修复此类尿道下裂 5例 ,效果满意 ,报道如下。1　临床资料1.1　一般资料5例病人平均年龄 4.2 (3～ 7)岁 ,均为阴囊型尿道下裂 ,伴阴茎弯曲畸形。1.2　手术方法全麻 ,仰卧位 ,尿道口插入Ｆ10 号气囊导尿管。在龟头上悬吊 1针便于牵拉阴茎。沿冠状沟切开 ,延伸至阴茎腹侧并绕过尿道外口 ,完全切除索状纤维组织 ,使阴茎伸直。在阴囊两侧各缝合 2针 ,使阴囊纵隔伸展开 ,按设计切开阴囊皮肤 ,7/ 0无损伤可吸收缝…     

带蒂阴茎、阴囊纵隔联合皮瓣正位尿道开口Ⅰ期尿道下裂成形术

目的 :探讨带蒂阴茎、阴囊纵隔联合皮瓣正位尿道开口Ⅰ期尿道下裂成形术的临床应用。　方法 :对 14 9例不同类型尿道下裂病人分别行带蒂阴茎、阴囊纵隔联合皮瓣正位尿道开口Ⅰ期成形术 ,并改进了引流形式。　结果 :一次排尿成功 12 2例 ,出现漏尿、包皮水肿 2 7例 ,其中尿道皮肤瘘 3例。　结论 :该手术方式适用于严重阴茎头型、阴茎型、轻度阴囊型的尿道下裂。该术式操作简单 ,易于掌握 ,但应注意术后感染的预防及引流管的护理     

足底内侧动脉带蒂岛状皮瓣逆行修复足底前部皮肤缺损

利用足底内侧动脉终末支与足底外侧动脉第一跖骨背动脉及足底深支吻合，设计逆行足内侧岛状皮瓣修复足底前部皮肤缺损5例，皮瓣全部成活。随访6个月～8年，外形与功能改善满意。足底内侧动脉带蒂岛状皮瓣逆行修复足底前部皮肤缺损方法简便，安全可靠，效果良好，且并发症少。     

局部转移皮瓣联合带蒂阴囊肉膜治疗尿道下裂术后尿漏

目的探讨局部转移皮瓣联合带蒂阴囊肉膜治疗尿道下裂术后漏尿的效果。方法58例尿道下裂手术后出现阴茎或阴囊部漏尿的患者,其中简单漏尿17例,复杂漏尿41例。有一次手术史者17例,二次手术史者23例,三次及以上者18例。所有患者采用局部转移皮瓣联合带蒂阴囊肉膜修复漏口。结果58例于术后14 d拔除U形支架管,排尿通畅。所有患者均一次修复成功,无术后漏尿和其它并发症。随防12-83月,均未出现术后远期并发症。结论局部转移皮瓣联合用带蒂阴囊肉膜治疗尿道下裂术后漏尿,成功率较高,效果满意。     

Anteriorly Pedicled Retroauricular Flap for Repair of Auricular Defects

The reconstruction of the auricle is aesthetically very demanding. Various techniques have been used depending on the defect size, the defect location, and tissue involved. For better wound control and result predictability, we developed an anteriorly pedicled retroauricular flap. We used this modified double-full-thickness skin graft in three patients. This anteriorly pedicled flap provides a visible wound surface which makes wound dressing easy. The aesthetic outcome is good and predictable. No major complications were encountered during surgery or the healing phase. All patients were satisfied with the outcome. The described method offers a good option for reconstructing larger auricular defects with local tissue.     

斜行包皮岛状皮瓣尿道成形术治疗尿道下裂

目的:探讨斜行包皮岛状皮瓣尿道成形术治疗尿道下裂的效果。方法:采用斜行包皮岛状皮瓣尿道成形术治疗尿道下裂51例。结果:所有病例均自正位尿道口排尿,尿道外口呈纵向裂隙状,阴茎的外观满意,无阴茎下弯或侧弯,并发症发生率11.8%(6/51),其中尿瘘3例,尿道外口狭窄3例。结论:本术式具有取材范围大、皮瓣血运可靠、成形阴茎外观满意、并发症少等优点,适合阴茎型和阴茎-阴囊型尿道下裂的I期修复。     

腓浅动脉逆行岛状皮瓣治疗小腿远端皮肤缺损

目的探讨采用腓浅动脉逆行岛状筋膜蒂皮瓣治疗小腿远端皮肤缺损的临床效果。方法采用腓浅动脉逆行岛状皮瓣治疗此种病人17例。术后根据皮瓣成活情况进行评价。结果随访17例,时间3周~5年,术后皮瓣完全成活14例。3例皮瓣远端部分坏死。结论采用腓浅动脉逆行岛状筋膜蒂皮瓣治疗小腿远端皮肤缺损,该皮瓣血供可靠,切取方便,不牺牲主干血管,基本可满足小腿下段创伤修复的需要。     

带旋股外侧血管横支大转子转移在股骨头修复与重建中的应用

在解剖学研究的基础上,设计了带旋股外侧血管横支的大转子骨瓣转移的方法,治疗股骨头无菌性坏死,自1991年1月以来,临床应用26例,有13例经二年以上随访,取得了满意疗效。作者详细介绍了手术设计、操作方法和临床效果等。     

A Case of Postmastectomy Defect Reconstructed Using a Laterothoracic Bilaterally Pedicled V-Y Advancement Flap

BACKGROUND: The reconstruction of major defects of the trunk is generally achieved by means of pedicled or free musculocutaneous flaps, but for less extensive defects, local flaps or skin grafts are currently used. The bilaterally pedicled V-Y advancement flap differs from the traditional V-Y advancement flap and was described for soft tissue reconstruction in the face. In our unit, the bilaterally pedicled V-Y advancement flap is the most used local flap for face reconstruction, and our aim was to use it in a different location. METHODS: In this case report we present a postmastectomy defect reconstructed with good results using the bilaterally pedicled V-Y advancement flap. RESULTS: The flap healed without further problems, and a good aesthetic result was obtained. CONCLUSION: The bilaterally pedicled V-Y advancement flap is reliable and easy to harvest, and not only for face reconstruction. Its versatility and plasticity allow its use for the reconstruction of many defects at varying locations.     

Large Chest Wall Reconstruction Using a Pedicled Osteomuscle Composite Flap: Report of a Case

A 67-year-old man with diabetes mellitus and chronic renal failure underwent resection of a grade 1 chondrosarcoma. We performed chest wall reconstruction of the massive defect, using a pedicled osteomuscle composite flap comprising the 6th, 8th, and 10th ribs, and the latissimus dorsi and serratus anterior muscles. This flap is ready to mobilize as a pedicled graft to cover a large chest wall defect; it is strong enough to buttress the chest cage without the need for artificial materials, and it is associated with a lower risk of infection than prosthetic materials.     

Repair of Full Thickness Defect of the Nose Using an Expanded Forehead Flap and a Glabellar Flap

We describe a method to repair full thickness defects of the nose using a glabellar flap as the lining of the nasal cavity and an expanded forehead flap for external closure. We consider our method useful in the reconstruction of a nose with a full thickness defect for which the flap donor site is limited. The patient was a 45-year-old man who underwent resection of a basal cell carcinoma located over the dorsum of the nose which was associated with a hemangioma simplex on the face. As a result, about two-thirds of the nose, from the dorsum to the tip, as well as a part of the right cheek became deficient and the right nasal cavity became exposed. The nose was reconstructed using the above-mentioned method. The result was satisfactory both cosmetically and functionally.