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61.
Constricting band penile injuries in children may be caused by inadvertent entrapment by a variety of agents including hair, thread, and circumcision dressings. Alternatively, the offending band may have been self-applied or applied by an attendant. Unrelieved, the band causes serious vascular occlusion, progressive tissue necrosis, and injury to the urethra and erectile tissue. We report a case of CBPI in a 12-year-old circumcised boy. The glans was attached to the penile shaft by a tenuous segment of tissue dorsally with complete transection of the urethra. A three-stage reconstruction using a delayed groin flap was successful. 相似文献
62.
63.
When the diaphragm is excised so wiely that the defect cannot be closed directly during an operation on either thoracic or
epigastric tumors, a reconstruction of the defect is necessary. We used harvested autologous fascia lata to reconstruct the
diaphragm in a patient undergoing a pleuropneumonectomy with a partial diaphragmatic resection for malignant mesothelioma. 相似文献
64.
The subcutaneous pedicled V-Y advancement flap (also known as the kite flap of Dufourmentel) has been described by many authors. Its versatility in reconstructive surgery is well known, both in facial reconstructive surgery as well as surgery of the trunk and extremities. Its advantages in achieving aesthetic reconstruction in specific facial regions have been less well emphasized in the literature. The flap can be designed within natural facial creases and heals inconspicuously because of its widely based subcutaneous or muscle pedicle which incorporates venous and lymphatic drainage over most of its length. The undesirable biscuiting or flap edema frequently observed with other conventional transposition flaps is avoided. We have found the V-Y flap particularly useful in reconstructing the lower eyelid/medial canthus, supra-alar, and nasolabial regions. Our experience with over 40 such flaps is described, and technical considerations in designing and elevating the flap are discussed. 相似文献
65.
C. Echinard 《European journal of plastic surgery》1996,19(4):178-184
Skin expansion in burn patients can be a useful method for secondary skin resurfacing, scar revision or facial remodelling. However, complications and problems occur more often in these patients than in any other. In this paper the incidence of complication in the first and second stages of expansion will be presented. Several rules will then be stated and we will clarify the indications for skin expansion in the treatment of hypertrophic scars, contractures, and post-burn destructions.Lecture given at the first State of the art course on burn reconstruction — Milano, May 1994 相似文献
66.
Frog motoneurons were intracellularly labelled with cobaltic lysine in the brachial and the lumbar segments of the spinal cord, and the material was processed for light microscopy in serial sections. With the aid of the neuron reconstruction system NEUTRACE, the dendritic tree of neurons was reconstructed and the length and surface area of dendrites measured. The surface of somata was determined with the prolate - oblate average ellipsoid calculation. Corrections were made for shrinkage and for optical distortion. The mean surface area of somata was 6710 microm2; lumbar motoneurons were slightly larger than brachial motoneurons. The mean length of the combined dendritic tree of brachial neurons was 29 408 microm and that of lumbar neurons 46 806 microm. The mean surface area was 127 335 microm2 in brachial neurons, and 168 063 microm2 in lumbar neurons. The soma - dendrite surface area ratio was 3 - 5% in most cases. Dendrites with a diameter of = 1.0 microm constituted approximately 75% of the combined dendritic length in most of the neurons. Unlike in the cat, there was no correlation between the size of stem dendrites and the extent of daughter branches. From the synaptic density estimated in earlier electron microscope investigations of frog motoneuron dendrites (Antal et al., J. Neurocytol., 15, 303 - 310, 1986; 21, 34 - 49, 1992), and from the present data, the number of synapses on the dendritic tree was calculated. The calculations indicated 26 949 synapses on the smallest and 61 519 synapses on the largest neuron if the synaptic density was multiplied by the length of the dendritic tree. If the synaptic density was multiplied by the surface area of the dendritic tree the calculation yielded 23 337 synapses for the smallest and 60 682 synapses for the largest neuron. More than 60% of the combined surface area of dendrites was >600 microm from the soma. This suggests that about two-thirds of the synapses impinged upon distant dendrites >600 microm from the soma. The efficacy of synapses at these large distances is investigated on model neurons in the accompanying paper (Wolf et al., Eur. J. Neurosci., 4 1013 - 1021, 1992). 相似文献
67.
C. L. Puckett M.D. F.A.C.S. M. J. Concannon M.D. G. H. Croll M.D. C. F. Welsh M.D. 《Aesthetic plastic surgery》1992,16(2):117-122
A new method of nipple reconstruction called the inchworm flap is described. The name comes from the manipulation method used to position the flap for nipple projection. Experience with over 50 patients and including 58 breasts has been reviewed. There was adequate followup for 36 breasts in which overall maintenance of projection was 78% for this technique. When used after submuscular expansion for breast reconstruction, maintenance of projection reached 89%. The technique of flap manipulation is described in detail. This flap appears to be a reliable method for obtaining moderate nipple projection, particularly in the submuscular expansion breast reconstruction cases. It is not recommended for use in TRAM flap cases.Presented at the annual meeting of the American Society of Aesthetic Plastic Surgery, Chicago, IL, April 1990 相似文献
68.
目的:探讨喉次全切除术后创面修复及喉功能的重建。方法:对33例喉癌患者行喉次全切除术。手术范围:切除舌骨,大部分甲状软骨板,会厌前间隙和声带、室带,保留一侧杓状软骨及一侧1/3甲状软骨板、1/3的声带。采用一侧的带蒂皮瓣、对侧带蒂的肌膜瓣修复创面和喉功能重建。结果:全部患者均恢复正常的呼吸、吞咽功能,93.9%拔除气管套管获得发声功能。随访2~5年,3例死于肿瘤以外的疾病,2例死于肿瘤多脏器转移。结论:喉次全切除术后,应用带蒂皮瓣和肌膜瓣修复创面,重建发声功能,具有取材方便、血运好、不易造成喉狭窄、缩短带管时间以及提高患者生存质量等优点。 相似文献
69.
螺旋CT三维重建在鼻骨骨折中的临床应用价值 总被引:9,自引:0,他引:9
目的:探讨螺旋CT三维成像对鼻骨骨折的诊断价值。方法:应用GE Lightspeed Plus多排螺旋机扫描仪,对46例鼻外伤患者进行鼻骨横断面扫描和三维重建成像,并对检查结果进行分析。结果:46例鼻外伤患者中,9例普通X线侧位平片未发现骨折(19.6%);CT图像均能清晰显示骨折线,其中单纯鼻骨骨折32例(69.6%),并发上颌骨额突骨折11例(23.9%),上颌窦骨折1例,筛窦纸样板骨折3例,鼻中隔断裂1例。结论:螺旋CT三维成像对于诊断鼻骨骨折具有重要的诊断价值。 相似文献
70.
目的 研究前交叉韧带重建(anterior cruciate ligament reconstruction, ACLR)术后短时间内移植体黏性的变化规律。方法 选择6只雄性新西兰兔,以跟腱为移植体制作单侧膝关节ACLR动物模型。ACLR术后15 d将实验兔安乐死,取出移植体、健康的前交叉韧带(anterior cruciate ligament, ACL)和跟腱。测量移植体的截面积,分别进行0.1、1 MPa平衡条件的蠕变实验,并计算黏性系数,总结移植体的黏性变化规律,与健康ACL进行对比。结果 移植体的截面积在手术后15 d内缓慢上升。ACL与移植体的黏性呈非线性变化。在不同应力下,黏性系数有较大差异。移植体黏性系数随ACLR术后时间呈下降趋势,但在低应力下更明显。结论 本文建议,ACLR术后早期康复过程中,应使用助行器,降低步频,并避免踢、踹等对关节冲击的运动。 相似文献