菊苓液冲洗对产后会阴切口的影响

目的:观察菊苓液冲洗对产后会阴切口的影响。方法:选取2016年1月—6月在本院分娩的孕妇1 000例,随机分为观察组521例和对照组479例。观察组给予菊苓液会阴冲洗,对照组给予高锰酸钾(1∶5 000,河北武罗药业有限公司生产,国药准字H13021323)溶液冲洗会阴切口,每天早晚各1次,连用3 d。比较两组产妇会阴切口愈合情况。结果:对照组甲级愈合率96.66%,观察组甲级愈合率99.23%,观察组优于对照组(P0.05)。结论:菊苓液冲洗能提高会阴切口愈合率,疗效优于高锰酸钾冲洗。     

The ‘French Fry’ VAC technique: hybridisation of traditional open wound NPWT with closed incision NPWT

Surgical site occurrences (SSO), specifically surgical site infections represent a significant burden in the US health care system. It has been hypothesised that postoperative dressing can help drive down SSO. We describe the successful use of a novel technique combining both closed incision and open negative pressure wound therapy in the management of a high‐risk wound associated with lymphoedema of obesity.     

Uterine incision-to-delivery interval and perinatal outcomes in transverse versus vertical incisions in preterm cesarean deliveries

Abstract

Objective: To compare the uterine incision-to-delivery interval and neonatal and maternal complications in vertical versus transverse uterine incisions in preterm cesarean births.

Methods: This is a retrospective cohort study of singleton cesarean deliveries from 2002 to 2009 between 23 and 34 weeks of gestation. Statistical analysis utilized Wilcoxon rank-sum test and multivariable logistic regression.

Results: Of the 773 singleton cesarean deliveries, 586 (75.8%) had a transverse uterine incision and 187 (24.2%) had vertical uterine incision (classical?=?134 and low vertical incision?=?53). After adjusting for confounders, there was no significant difference in incision-to-delivery interval between the two types of incisions. The risk for maternal transfusion was higher among those with a vertical incision (odds ratio: 2.17; 95% confidence interval: 1.00, 4.67) than those with a transverse incision. Incision type was not associated with any neonatal outcomes studied, including intraventricular hemorrhage, Apgar scores and neonatal mortality.

Conclusion: We observed no difference in Uterine Incision-to-Delivery interval and neonatal complications between vertical and transverse incision. Performance of a vertical uterine incision for the sole reason of facilitating a more rapid delivery is not justified. Development of methods to better determine transverse incision feasibility may facilitate a decrease in vertical uterine incisions.     

中医外治法在肛瘘术后切口愈合中的应用

肛瘘术后创面愈合的质量在肛瘘治疗中占重要地位,而术后的正确用药是保证创面愈合的关键。中医药在促进肛瘘术后创面愈合方面方法良多,文章对中医外治法在肛瘘术后切口愈合中的应用进行综述。     

潘立群教授治疗粉刺性乳痈的临床经验

介绍了潘立群教授治疗粉刺性乳痈的临床经验。认为应在了解本病病理解剖学的前提下,基于患者的病机,结合月经周期,运用内托法逼毒外出;同时施以外治法,尤其提倡循病灶走向的小切口引流,以避免传统切开排脓法对于乳房各结构尤其是乳导管的大规模破坏,遂使乳房毁损趋于微小,得以维护其外形的基本完整,从而有效地发挥中医外科内、外治法相结合的学术优势。<     

内侧副韧带单切口重建与双切口重建对治疗膝关节内侧不稳定的疗效分析

目的 回顾分析同种异体肌腱单切口重建内侧副股韧带和双切口重建内侧副股韧带的临床疗效差异.方法 选取2010年1月至2012年12月我院收治的膝关节内侧不稳定患者26例(26膝),均采用内侧副韧带重建;其中单切口重建内侧副韧带12例,双切口重建内侧副韧带14例.术前、术后按照IKDC及Lysholm评分评价膝关节功能并测量术后膝关节内侧开口、膝关节活动度、膝关节稳定性.结果 所有患者均获得随访,术后平均随访26个月(14～49个月).末次随访2种方法术后IKDC评分分别为(84.33±7.85)分和(84.21±7.67)分;Lysholm评分分别为(84.41±8.67)分和(84.5±7.52)分,与术前相比评分明显提高;2种方法术后IKDC及Lysholm评分比较差异无统计学意义(P＞0.05).关节活动度与内侧关节间隙在术后得到明显改善,2种方法的术后测量值差异无统计学意义(P＞0.05).结论 单切口重建内侧副股韧带和双切口重建内侧副股韧带治疗膝关节内侧不稳定的临床疗效相同.     

小切口去脂联合连续埋线重睑术在不对称双眼皮中的效果

目的 探究对不对称双眼皮患者应用小切口去脂联合连续埋线重睑术的效果。方法 将2022年 1月-2023年10月江苏省沭阳祐慈医疗美容诊所收治的不对称双眼皮患者160例分为对照组和观察组,每组 80例。对照组行常规切开重睑术治疗,观察组行小切口去脂联合连续埋线重睑术治疗,比较两组围术期指 标、炎性因子水平、并发症发生率及术后3个月满意度。结果 观察组术中失血量少于对照组,手术时间、 刀口愈合时间、首次下床活动时间及住院时间短于对照组（P ＜0.05）;观察组术后3 d的IL-6、CRP、 TNF-α水平低于对照组（P ＜0.05）;观察组并发症发生率为1.25%,低于对照组的8.75%（P ＜0.05）;观 察组术后3个月总满意度高于对照组（P ＜0.05）。结论 对于不对称双眼皮患者,采用小切口去脂联合连 续埋线重睑术可促进其术后恢复,降低炎症因子,减少并发症发生情况,进而提高患者满意度。     

微创负压抽吸术治疗腋臭的临床效果

目的 探究微创负压抽吸术治疗腋臭的可行性。方法 选取烟台市奇山医院医疗美容科2022年 6月-2023年8月收治的60例腋臭患者为研究对象,采用随机数字表法分为参照组和研究组,各30例。参照 组予以小切口汗腺切除术治疗,研究组予以微创负压抽吸术治疗,比较两组临床疗效、手术指标、日常活 动评分及并发症发生情况。结果 研究组治疗总有效率为96.67%,高于参照组的76.67%,差异有统计学意 义（P＜0.05）;研究组手术用时、术后固定时间、切口愈合时间以及术后住院天数短于参照组,差异有统 计学意义（P ＜0.05）;研究组HDSS评分低于参照组,差异有统计学意义（P ＜0.05）;研究组术后并发症 发生率为3.33%,低于参照组的26.67%,差异有统计学意义（P＜0.05）。结论 腋臭治疗中应用微创负压抽 吸术的效果较小切口汗腺切除术更优,可促进康复,降低并发症发生几率,临床应用价值较高。     

Feasibility of using the postauricular-groove approach without endoscopic assistant for excision of parotid tumors. Results from a series of 58 cases

The aim of the study was to evaluate the efficacy and preliminary outcomes of using a postauricular-groove approach without endoscopic assistance for the excision of parotid tumors.Patients who underwent parotidectomy using a postauricular-groove incision were selected for this study. For patients in which parotidectomy was difficult, namely, for tumors located in the deep lobe area, the parotid gland sternocleidomastoid space was fully utilized, and the tumor was resected from the posterior plane. A total of fifty-eight patients with parotid tumor were enrolled and divided into superior lobe group (n = 46) and deep lobe group (n = 12). The difference in operation time (94 vs 119 min) and postoperative drainage (20.18 vs 45.33 mL) was statistically significant between the tumors in the superficial and deep lobes. However, postoperative cosmetic VAS score was 10 (extremely satisfied) for all patients. The incidence of transient facial nerve paralysis was comparable (8.7% vs 16.7%), and all of them resolved spontaneously within 3 months. No recurrence of tumors was found in either group in the median follow-up interval of 26.45 months (range 22.2–35.3 months), which was comparable to the result using the conventional “S” approach.After making full use of the parotid gland sternocleidomastoid space, the postauricular-groove approach demonstrated satisfactory facial nerve protection, as well as easy maneuverability without the risk of surgical complications for tumors located in the deep lobe area. Importantly, the postauricular-groove approach showed excellent cosmetic outcomes for all patients and should be considered an alternative approach for parotidectomy of selected cases.