A clinical comparison of the new attachment obtained by guided tissue regeneration and coronally positioned flap techniques in the management of human molar furcation defects

The present clinical trial was designed to evaluate the regenerative potential of the periodontal tissue in Class II furcation defects in mandibular molars using reconstructive surgery based on the guided tissue regeneration (GTR) technique versus the coronally positioned flap (CPF) technique. After the completion of the initial phase of therapy and four to six weeks healing period, 20 furcation-involved molars were examined for baseline data which included plaque index, gingival condition, probing depth (PD), probing attachment level (PAL-V, PAL-H) and radiographs. All parameters were reexamined after three, six and twelve months of healing, except PD, PAL-V and PAL-H which were not measured at three and six months. A nonparametric analysis was used. The study showed that there were no significant differences in the mean baseline measurements between the treatment groups. After 12 months following surgical treatment, both GTR and CPF procedures showed gains in new clinical attachment levels. When comparing parameters between the two surgical procedures, GTR molars showed significantly more improvement in probing depth as well as vertical and horizontal attachment level of the interradicular osseous defect than did the CPF molars (p < 0.05). About 80 per cent of the sites treated with the GTR technique showed complete clinical resolution of the furcation problem. CPF therapy reached the same Treatment goal in about 50 per cent of the cases which were treated. Guided tissue regeneration appeared to be more effective in promoting regeneration than the coronally positioned flap.     

带蒂髂腹股沟轴型皮瓣移植术后血管危象原因的分析

目的 为提高IASFT成活率．降低血管危象发生率。方法 对7例IASFT术后血管危象患者资料进行回顾性分析。结果 本组中女性肥胖患者占5例,皮辫设计不合理占4例,皮辫止血不彻底招致感染2例,解剖结构不熟悉致损伤供血血管1例。结论 对适应症的合理选择和皮辫的设计恰当与否可能是预防带蒂髂腹股沟轴型皮辫移植术后血管危象的关键。     

自体微粒皮移植加异体异种皮覆盖在大面积深度烧伤中的应用

目的 评价自体微粒皮移植加异体、异种皮覆盖在救治大面积深度烧伤中的效果。方法 选择16例深度烧伤病人,烧伤面积15％～92％,平均55.9％±21.8％,正度面积7％～60％,平均33.6％±15.7％,其中5例合并有吸入性损伤。16例采用早期切削痴自体微粒皮移植加异体、异种皮覆盖,同时观察不同覆盖皮种的效果。结果 16例除1例死亡全部治愈。异体皮比异种覆盖修复创面快,残余创面少,亲属皮和尸胎皮效果最好。结论 自体微粒皮移植加异体、异种皮覆盖治疗大积深度烧伤效果可靠。     

胸锁乳突肌瓣在头颈肿瘤手术中的应用

目的　探讨以上端为胸锁蒂的乳突肌组织瓣在头颈肿瘤术区中型缺损的作用。方法　对６ 例应用胸锁乳突肌复合组织瓣修复头颈肿瘤术区缺损情况进行回顾性总结。６例病人中,１例为颞下窝肿瘤术区缺损的修复;３ 例修复腮腺颌后区缺损;１例对喉癌术区口咽侧壁修复;１例为对侧颈部术区缺损的修复。结果　５例胸锁乳突肌肌瓣的修复全部存活,１ 例胸锁乳突肌肌皮瓣的修复为延迟性坏死。结论　该肌瓣／肌皮瓣在头颈肿瘤术区中型缺损的修复有其重要意义,尤对保留面神经的腮腺颌后缺损,颅底区及咽侧壁缺损的修复意义更加明显     

Primary reconstruction by modified cervical island skin flap following resection of oral and pharyngeal cancer

Summary Reconstruction of the intraoral defect following cancer surgery often causes formation of fistula, impairment of lingual movement, and prolonged hospitalization by secondary reconstruction. To reduce such complications, the modified cervical island skin flap method as a one-stage intraoral reconstruction was used in 18 patients. Lateral cervical island flap was used in 15 cases and the median flap in three. This method proved to be successful for 17 patients. One patient who received a preoperative full dose of irradiation developed a fistula. There were two types of healing of the skin flap. The postoperative external appearance and function of the tongue were commendable.     

游离皮瓣修复口腔癌术后缺损感觉恢复的研究

目的:评估非感觉性游离皮瓣修复口腔癌术后缺损感觉功能的恢复情况。方法:追踪16例口腔癌患者,其中游离腓骨肌皮瓣修复下颌骨缺损8例,游离前臂皮瓣修复舌缺损8例,术后6-18个月检测移植后皮瓣的轻触觉、两点辨别觉、痛觉和冷热觉的恢复情况。结果:7例皮瓣(43.7%)至少2/3面积有感觉恢复,8例皮瓣(50%)有部分感觉恢复,1例皮瓣(6.3%)无感觉恢复。结论:非感觉性游离皮瓣修复口腔癌术后缺损可自行恢复部分感觉功能。     

Management of heel ulcers in insensate foot by using free prefabricated radial fascial flap — a new flap

Heel ulcers are common in insensate foot. The management of such ulcers require tissue not only to resurface the skin defect, which is small in most of the cases; but also well vascularised tissue to fill the cavity which results after excision of the ulcer. We have described a new flap prefabricated radial fascial flap, by which both aims are achieved easily.     

肩胛皮瓣游离移植修复面颈部皮肤缺损

目的　总结 1982年～ 1998年应用不同形状的肩胛皮瓣游离移植治疗面颈部损伤 10 3例。方法　游离皮瓣包含旋肩胛动脉升支、降支、水平支的肩胛背部皮瓣 ,设计范围为 :向上越过肩胛冈达肩峰连线 ,向下可平双侧髂嵴连线 ,两侧至腋中线的整个背部。结果　手术取得良好效果。术后随访 5 8例 ,随访时间 3个月～ 10年。面颈部功能恢复良好 ,外形满意 ,但患者均需要进行二次皮瓣修薄术。结论　应用肩胛皮瓣的最大范围可达45 cm× 16 cm。皮瓣的设计横向越过背部中线达对侧肩胛区 ,向上越过肩胛冈 ,向下达双侧髂嵴平面 ;在皮瓣适当部位开窗均不影响游离皮瓣的血运。皮瓣供区范围广 ,血供丰富 ,更适用于儿童面颈部修复