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81.
Peter A. Blume DPM FACFAS J. Christopher Moore DPM David C. Novicki DPM FACFAS 《The Journal of foot and ankle surgery》2005,44(1):44-48
There are a number of proposed causes and treatment approaches for digital mucoid cysts. The described treatment outcomes for this cyst have been variable, with the highest success rate reported with complete excision and single-lobe skin flap closure. This report describes a bilobed flap reconstruction in conjunction with resection of the head of the middle phalanx. A retrospective review was undertaken to evaluate the recurrence rate, complications, and patient satisfaction with this combined procedure. Fifteen patients with an average follow-up of 4.6 years were evaluated. There were no recurrences, flap failures, or other major complications. The use of this flap allows for greater exposure than traditional semi-elliptical incisions while allowing the wide excisional defects to be closed primarily. 相似文献
82.
[目的] 探讨皮(肌)瓣治疗骨坏死的可行性。[方法]应用新西兰大白兔48只,随机分为对照组、实验组。按实验方法将胫骨制成骨坏死模型。对照组用游离皮片覆盖坏死骨;实验组用腓肠肌皮瓣覆盖坏死骨。术后2、4、8、12周行ECT、X线片、骨钙素(BGT)、组织切片检查。临床应用436例。[结果]ECT显示实验组动脉相放射摄入值及延迟相放射摄入值明显高于对照组(P〈0.02);血清BGP水平实验组各时段均比对照组高(P〈0.001);组织学检查4周实验组髓腔中可见增生的血管,大量骨细胞;X线片12周实验组的胫前皮质骨接近正常骨,而对照组皮质骨仍为坏死、骨质硬化。临床应用小腿外观好,足部肿胀消退,创面感染治愈,坏死骨成活,骨髓腔再通。[结论]用血运丰富的皮(肌)瓣覆盖坏死胫骨段后,血运改善,坏死骨可以成活。 相似文献
83.
84.
目的 探讨手术治疗头面部不同类型毛细血管畸形的适应证,手术方法及疗效.方法 对适合手术的23例头面颈部患者,根据病灶的面积和手术前的条件分别采用了植皮,扩张器局部皮瓣转移修复和游离皮瓣修复等方法,并进行术后评价和随访.结果 除一例特别原因造成皮片下积血,皮片部分成活不良二期再植,一例同位素治疗后扩张器病例远端发生血运障碍后改植皮以外,其余皮片,皮瓣均成活良好,但随访皮片有较明显的色差,而皮瓣色泽,质地良好.结论 皮瓣修复效果较好,其中扩张的局部皮瓣转移修复效果最佳.游离皮瓣较适合有皮下组织萎缩的大面积的病例,而其他大面积病灶可采用分期分区植皮. 相似文献
85.
86.
Naoya Katsuragi Yutsuki Nakajima Yuji Shiraishi Masahiro Hashizume Nobumasa Takahashi 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(8):440-442
We describe a case of a large bronchial fistula and empyema after right upper lobectomy that was treated successfully with
open window thoracostomy followed by a latissimus dorsi myocutaneous flap and limited thoracoplasty. A latissimus dorsi myocutaneous
flap can provide immediate airtight closure of a large bronchial fistula, allowing lavage and curettage of the empyema cavity
to reduce the chance of postoperative infection. An important aspect of this technique is that the deepithelialized skin side
rather than muscle is sutured to an opening of the bronchus. As compared with other techniques, a latissimus dorsi myocutaneous
flap is superior in that it requires a single incision and does not require an intraop-erative change of position. In addition,
the technique causes little dysfunction of the chest and shoulder and preserves the vascular supply to ensure the viability
of the flap even if it was divided in a previous operation. 相似文献
87.
定向皮肤扩张器在面颈部瘢痕治疗中的应用 总被引:14,自引:9,他引:5
目的:探讨定向扩张器在治疗面颈部瘢痕中的临床应用。方法:回顾性分析我科2000年至2004年用定向扩张器治疗48例面颈部瘢痕患者。手术分两期:先于瘢痕附近正常皮下置入定向扩张器,皮肤充分扩张后行扩张器取出、瘢痕切除、局部皮瓣转移。结果:48例患者共治疗56处瘢痕,置入扩张器60个,一次修复最大面积为12cm×16cm,除5例遗留部分瘢痕经第二次皮肤扩张修复外,所有患者均得到有效治疗;扩张期并发症18处(30%),以扩张器外露最多见。结论:定向皮肤扩张器在面颈部瘢痕治疗中有很大的应用价值。但应重视预防并发症。 相似文献
88.
89.
Péter Móricz Imre Gerlinger Jenő Solt Krisztina Somogyvári József Pytel 《European archives of oto-rhino-laryngology》2007,264(12):1441-1445
Stenosis of the hypopharyngo-oesophageal junction can be a rare complication of laryngectomy and/or partial pharyngectomy
and makes the insertion of voice prosthesis extremely difficult. This study describes the authors’ experiences gained by endoscopic
balloon-catheter dilatation of hypopharyngo-oesophageal stenoses prior to implantation of voice prostheses in four cases.
In two patients a single balloon-catheter dilatation resulted in wide enough pharyngo-oesophageal lumen on the long run. The
average prosthesis wearing-times were 6.8 months in case 1 and 4.6 months in case 2, corresponding to the published literature
data. In case 3, repeated dilatation of the pharyngo-oesophageal transition had proved to be unsuccessful despite taking every
effort with the endoscopic balloon-catheter method. Having excised the stenotic segment, reconstruction with pectoralis major
myocutaneous flap (PMMF) was indicated. Eighteen months later, a repeated restenosis was observed and a free jejunal flap
needed to be performed as a final solution. In case 4, the insertion was carried out into a previously dilated jejunal free
flap, which became gradually ischemic and stenotic since the major head-and neck procedure was carried out that resulted in
prosthesis rejection after just 1 week. The authors emphasize that correct indication of pedicled and free flaps in head and
neck reconstruction is a prerequisite from the aspect of prevention of pharyngo-oesophageal strictures. Endoscopic balloon-catheter
dilatation is a safe and established method for dilatating hypopharyngo-oesophageal stenoses of different origin. The procedure
provides maximum patient benefit with minimal trauma and morbidity; moreover, facilitates insertion of voice prostheses. However,
a single balloon-catheter dilatation cannot always result in wide enough oesophageal lumen on the long run (case 3). Insertion
of a voice prosthesis into a previously dilated ischemic jejunal segment is challenging and avoidable due to risks of complications. 相似文献
90.
处女膜修补手术及麻醉方法的改进 总被引:9,自引:7,他引:2
目的;增大处女膜粘膜瓣的接触面,减少因麻醉造成的处女膜粘膜水肿,提高修复手术的成功率。方法:手术全部采用1%的卡因行粘膜表面麻醉。53例采用瓦合粘膜瓣法,3例用瓦合粘膜瓣联合阴道粘膜瓣修复法。结果:56例术后一月随访,53例处女膜孔径为一指,成功率94.64%。结论:采用1%的卡因粘膜表面麻醉,瓦合粘膜瓣法及瓦合粘膜联合阴道粘膜瓣修复法对处女膜修复是行之有效的。 相似文献