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101.
102.
103.
目的 探讨不同方案缺血预处理(ischemic preconditioning,IPC)对大鼠横形腹直肌肌皮瓣(transverse rectus abdominis musculocutaneous flap,TRAM)移植后再灌注损伤的影响。方法选取雄性Wistar大鼠90只,建立TRAM模型,随机分为对照组和实验组,对照组10只,无需预处理过程,持续缺血4h后,恢复肌皮瓣血供;实验组分为8个亚组,每组10只,以微血管夹阻断腹壁下血管5min,再恢复血流5min,处理1次为sIPC5/5组,处理2次为bIPC5/5组,依次为sIPC5/10组(缺血5min/再灌注10min1次)、bIPC5/10组(缺血5min/再灌注10min2次)、sIPC10/5组(缺血10min/再灌注5min 1次)、bIPC 10/5组(缺血10min/再灌注5min2次)、sIPC10/10组(缺血10min/再灌注10min1次)、bIPC10/10组(缺血10min/再灌注10min2次),其余实验步骤与对照组相同;每组肌皮瓣恢复血供4h后,取3只处死取材,测定肌组织含水量及HE染色镜检观察骨骼肌组织结构,其余动物于术后第7天判断皮瓣成活情况,计算成活面积百分比。结果恢复血供12h后,各实验组肌皮瓣两侧边缘部分肿胀,色泽黯淡,较对照组肿胀范围小,程度轻;光镜下见各实验组肌纤维轻度肿胀,染色均一,肌纤维结构尚完整,胞核呈梭形,无明显肿胀。对照组肿胀明显,部分肌纤维断裂。各实验组与对照组相比肌组织水含量明显减少(P〈0.001),皮瓣成活面积提高了2~3倍(P〈0.001)。两次预处理对肌皮瓣成活面积的影响与相应的单次预处理比较,差异有统计学意义(P〈0.05)。结论IPC可明显减轻大鼠TRAM再灌注损伤程度,其保护效应受缺血/再灌注时间、处理次数等因素的影响。 相似文献
104.
带血管蒂跗骨瓣移位术修复踝及足部骨病损 总被引:6,自引:2,他引:4
目的 为治疗踝及足部骨质病损提供系列手术方式。方法 在解剖学研究基础上,设计了带血管蒂的骰骨瓣、内侧楔骨瓣、舟骨瓣和跟骨前外侧骨瓣移位术,以修复踝及足骨质病损。临床应用55例。结果 术后经l—10年随访48例,平均为4年6个月,疗效满意。结论 上述4种跗骨瓣均具有血管蒂位置表浅、解剖容易和手术安全可靠等优点。 相似文献
105.
Rainer O. Seidl Ingo Todt Arne Ernst 《European archives of oto-rhino-laryngology》2007,264(3):291-293
We report on a case of esophageal atresia following cervical spine surgery. A swallowing examination was performed using fibre-optic
endoscopy and videofluoroscopy. There was scar tissue fixation of the larynx and esophagus to the cervical spine. Operative
mobilization of the larynx and esophagus and formation of a sliding layer using a platysma-fascia flap was done. The PEG and
tracheal cannula were removed; oral nutrition was initiated after 3 months. Swallowing disorders following operations on the
upper cervical spine should be investigated. Careful preparation that preserves the layers should be carried out. Fixation
of tissues as a result of scarring should be treated with a sliding layer. 相似文献
106.
Cevat Uçar 《European archives of oto-rhino-laryngology》2006,263(12):1082-1086
We used inferior pedicled composite multi-fractured osteoperiosteal flap (CMOF), our original and new surgical approach, to obliterate the mastoid cavity and reconstruct the external auditory canal (EAC) to prevent the open cavity problems. CMOF was used to obliterate the mastoid cavity and reconstruct the EAC in 24 patients (13 women, 11 men; age span 12–51 years) who underwent radical mastoidectomy to treat the chronic otitis media between 1998 and 2004. Small meatoplasty was done in all 24 patients to relive their aesthetical concerns. Temporal bone CT scanning was done to observe the neo-osteogenesis in the mastoidectomy cavity and the CMOF, and the EAC volume was measured postoperatively. All our patients were followed-up for 2 years. The epithelization of the new EAC in our patients was complete at the end of the second month. Cholesteatoma, granulation, and recurrence of osteitis did not occur in any of the patients. We saw the new bone formation filling the mastoid cavity in the postoperative temporal bone CT scanning images. The mean volume of the new EAC on the 24th month was 1.83 ± 0.56 cm3. We had an almost natural EAC, which owed its existence to the neo-osteogenesis that grows behind the CMOF, which we use to obliterate the mastoid cavity and to reconstruct the EAC.This technique, composite multi-fractured osteoperiosteal flap, was presented in the symposium of Gulhane Military Medical Academy on otology and audiology, 15–18 September, 2005, Antalya, Turkey. 相似文献
107.
Summary The rectus abdommis myocutaneous flap, based on the deep inferior epigastric vessels, is an excellent flap for reconstructing
large wounds of the groin and perineum. However, wound infection in the donor site is a potential complication, even with
thorough preparation of the recipient site. We present one such case in a diabetic patient who developed a necrotizing fasciitis
and evisceration following transfer of an inferiorly based myocutaneous flap. 相似文献
108.
Foropenseverewoundandthewoundafterdebridement,mostscholarsthinkthewoundshouldbeclosedindelayedfirst-phase.Meshrelaxingshortincision(MRSI)methodcanclosemoreskindeficiencyandhightensionopenwound,andavoidsubcutaneoushematomaandskinflapdrift.Intheexperiment,theexperimentalmodelonrattensionskinflaphasbeeninvolved,andthecontentofendothelin(ET)inratskinflaptissuehasbeenmeasuredinvariousperiodofwoundhealingaftermeshedrelaxingshortincisionsuturewithimmunohistochemistry,inordertodiscussprobablemechani… 相似文献
109.
阔筋膜皮瓣移植修复手前臂巨大创面 总被引:4,自引:0,他引:4
报道采用吻合血管的阔筋膜皮瓣移植,修复手、前臂巨大创面11例,均获成功,其优点:①阔筋膜长而坚韧,内面光滑,覆盖关节、骨、肌腱粘连轻,尤其利于肌腱滑动,是修复手、前臂的最佳皮瓣。②皮肤与肌腱同时缺损时,利用阔筋膜修复肌腰,一期完成肌腱及皮肤的修复。③股外侧皮神经长而粗,分支多,适合手部感觉修复。④供区隐蔽,皮下组织簿,血运丰富,供皮及阔筋膜面积大。 相似文献
110.
Porcine models have been used extensively for skin flap research because of the established similarity between the cutaneous
blood supply of the swine and humans. The Yucatan minipig provides an excellent model for researching the properties of random
cutaneous flaps, offering several advantages over other breeds of swine. In this study, a total of 67 random cutaneous dorsal
flank flaps measuring 4 × 14 cm were raised on nine Yucatan minipigs. The mean survival length (10.03 ± 1.60 cm) of the nondelayed
flaps was greater than others reported in the literature. The well-defined plane between the subcutaneous tissue and the panniculus
carnosus facilitated flap elevation consistently above the level of the panniculus carnosus thereby ensuring the creation
of a true random cutaneous flap. Furthermore, the hairless nature of the skin, particularly beneficial in studying chemical
peels, permits easy visualization and monitoring of any external skin changes. These advantages make the Yucatan minipig a
more desirable alternative to other breeds of swine for use in skin flap research. 相似文献