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91.
Annika Senghaas Thomas Kremer Volker J. Schmidt Leila Harhaus Christoph Hirche Ulrich Kneser Amir K. Bigdeli 《Microsurgery》2019,39(2):174-177
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72‐year‐old morbidly obese female patient with Clostridium septicum‐related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full‐thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration. Finally, the composite defect was successfully reconstructed through a contralateral extended free transverse rectus abdominis myocutaneus (TRAM) flap (50 cm × 38 cm). An arterio‐venous loop to the superficial femoral vessels using the great saphenous vein was necessary to allow the flap to reach the defect. Postoperatively, a minor wound healing disorder of the flap was successfully treated with split skin grafting. Six month after surgery, the patient presented with a completely healed flap coverage area and a small abdominal hernia without the need of further surgical revision. This case illustrates the use of a sliding free TRAM flap for closure of a massive abdominal wall defect. 相似文献
92.
George M. Pamboris Marika Noorkoiv Vasilios Baltzopoulos Amir A. Mohagheghi 《Scandinavian journal of medicine & science in sports》2019,29(2):200-212
The acute effects of two dynamic stretching (DS) protocols on changes in the ankle range of motion (RoM), neuromechanical, and sensorimotor properties of the plantarflexor muscle group were examined. Eighteen participants received slow (SDS) or fast dynamic stretching (FDS) on two separate days. Outcome measures were assessed pre‐ and 2 minutes post‐interventions, and included maximum dorsiflexion angle, maximum isometric torque at neutral ankle position, maximum concentric and eccentric torques, force matching capacity, joint position sense and medial gastrocnemius muscle and tendon strain. Possibly and likely small increases in dorsiflexion RoM were observed after SDS (mean ± 90% confidence intervals; 1.8 ± 1.2°) and FDS (2.1 ± 1.2°), respectively. Very likely moderate decreases in muscle strain after SDS (?38.0 ± 20.6%) and possibly small decrease after FDS (?13.6 ± 21.2%) were observed. SDS resulted in a likely beneficial small increase in tendon strain (25.3 ± 29.7%) and a likely beneficial moderate increase after FDS (41.4 ± 44.9%). Effects on strength were inconsistent. Possibly small effect on positional error after SDS (?27.1 ± 37.5%), but no clear effect after FDS was observed. Both DS protocols increased RoM, and this was more due to an increase in tendon elongation rather than the muscle. However, SDS showed greater improvement than FDS in both neuromechanical and sensorimotor performance, and hence, SDS can be recommended as part of warm‐up in sporting contexts. 相似文献
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Pamela P. W. Lee Koon-Wing Chan Tong-Xin Chen Li-Ping Jiang Xiao-Chuan Wang Hua-Song Zeng Xiang-Yuan Chen Woei-Kang Liew Jing Chen Kit-Man Chu Lee-Lee Chan Lynette Pei-Chi Shek Anselm C. W. Lee Hsin-Hui Yu Qiang Li Chen-Guang Xu Geraldine Sultan-Ugdoracion Zarina Abdul Latiff Amir Hamzah Abdul Latiff Orathai Jirapongsananuruk Marco H. K. Ho Tsz-Leung Lee Xi-Qiang Yang Yu-Lung Lau 《Journal of clinical immunology》2013,33(7):1269-1270