GREATER OMENTUM-CUTANEOUS AXIAL FLAP A METHOD TO CREATE TRANSFERABLE SKIN FLAP

In view of the fact that the blood vessels of the donor area for a free flap must be of an "axial pattern", that not all axial pattern flaps which are supplied by a direct cutaneous artery, are suitable for clincial applications, and that the availability of these flaps is greatly limited in patients with severe burns or multiple injuries, we have deviced a kind of new flap, the greater omentum-cutaneous axial flap, to replace the conventional free flap in plastic and reconstruc- tive surgery. Preliminary clinical application of this type of flap in 3 cases proved successful.     

阔筋膜张肌皮瓣游离移植

阔筋膜张肌皮瓣游离移植手术Hill等1978年首次报道。该肌血运来自旋股外侧动脉的升支。覆盖在肌肉上之皮肤由肌肉的穿支即肌皮动脉供给血运,因此它可作为肌肉皮瓣供游离移植之用。阔筋膜张肌为辅助的髋关节屈曲及外旋肌,功能不十分重要,切取后不影响原有功能,而且旋股外侧动脉之升支直径在2毫米以上,吻合血管困难不大,可供游离移植之用。我们于1979年7月为一例左足跟不稳固瘢痕病例施行阔筋膜张肌皮瓣游离移植手术,皮瓣完全成活。     

异体大网膜及自体皮片移植修复创面—动物实验初步报告

应用显微外科技术后,对需要带蒂皮瓣移植的创面,可用吻合血管的大网膜及自体皮片移植或吻合血管的各种皮瓣来修复。在这方面最早应用大网膜的是Melern 和 Buncke(1972),我院在1977年12月也开始用于临床。我们认为,它突出的优点是不受创面形状的限     

腓骨比目鱼肌瓣移位治疗胫前软组织及胫骨缺损

目的 探讨应用腓骨比目鱼肌瓣一次修复胫前软组织及胫骨缺损可行性。方法 采用新鲜成人尸体标本，通过解剖和灌注了解比目鱼肌和腓骨的血运来源，确定骨肌瓣的旋转蒂和旋转方向。结果 通过尸体解剖和临床应用证明了比目鱼肌和腓骨的血运均来自腓动脉。可以腓动脉的近端或远端为蒂，经骨间膜的外后方转移骨肌瓣修复软组织和骨缺损。结论 采用腓骨比目鱼肌瓣可一期完成对胫前软组织及胫骨缺损的修复，确保了移植骨的愈合，提高了手术的成功率。     

EARLY VASCULAR GRAFTING TO PREVENT UPPER EXTREMITY NECROSIS AFTER ELECTRICAL BURNS Beijing Jishuitan Hospital,, Beijing

Since May 1972, vein grafts have been used tO restore circulation in electrical injuries of the upper extremity when the wrist is the center of electrical injury associated with obstructed blood supply. Saphenous vein grafts were used in 15 limbs of 14 patients where wrist electrical in- juries threatened complete hand loss. Ten of the hands were free of necrosis with motion and sensibility basically recovered. The other 4 (5 limbs) failed operatively for va.riolus reasons, resulting in forearm amputatiom Clinical prac- tice shows that successful surgery depends upon whether secondary infection is effectively con- trolled, particularly in those who are brought to the hospital late Wjth wound infection finger gangrene. This paper reviews the measures for controlling postoperative infections in vascular grafts to restore wrist blood flow and the clinical experience gained in the successful treatment of these patients (6 injured limbs of 6 cases), pre- venting amputation. We hope the method will be improved and its use broadened.     

用前臂游离皮瓣进行颊粘膜、口咽、舌再造术

随着肿瘤的诊断及治疗技术的提高,患者5年及10年生存率也不断地上升,对术后功能和外形的要求也越来越迫切。我院头颈外科应用显微外科技术,为肿瘤患者用前臂游离皮瓣进行颊粘膜、口咽、舌再造3例,报告如下: [例1]女,34岁,右颊粘膜分化差的粘液表皮样癌,肿物大小4×5×6cm,充满整个颊侧,行颊粘膜癌     

两次应用腓动脉供血行游离组织移植一例报告

两次应用腓动脉供血行游离组织移植一例报告王洪业，王丹，刘建寅，程绪西患者男，５５岁。１９９０年３月被铲车铲刀挤伤。右小腿开放骨折，胫骨缺损１１ｃｍ，胫前动脉缺损１６ｃｍ，大隐静脉缺损１４ｃｍ，小腿创面１２ｃｍ×１０ｅｍ，曾先后两次扩创，死骨摘除，游离...     

大纲膜底轴型皮瓣——一种形成游离皮瓣的新技术

游离皮瓣移植手术虽然只有数年的历史,但应用范围已很广泛。起初,切取皮瓣的来源主要是腹股沟处。通过尸体解剖及动物实验的研究,发现了一些新的可供移植的皮瓣,其中足背皮瓣比较理想。尽管如此,由于人类皮肤血管分布的特点,游离皮瓣的来源仍然受到较大的限制。     

比目鱼肌瓣移位修复小腿慢性骨髓炎软组织缺损

目的：应用比目鱼肌肌瓣移位修复伴有慢性骨髓炎的小腿和踝部软组织缺损。方法：采用结扎胫后动脉远端或近端，结扎胫后动脉远端分支或近端分支，以比目鱼肌内侧头近端或远端为蒂移位修复软组织缺损，其中面积最大为１３ｃｍ×１０ｃｍ。结果：８例中，有５例伤口Ｉ期愈合，２例植皮部分坏死，１例肌瓣远端１／３坏死，随诊１～２年，骨髓炎无复发。结论：该肌瓣对小腿功能影响小，血运丰富，转移方便，适用于小腿和踝部骨髓炎软组织缺损的修复。