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System describing surgical field extension associated with flap reconstruction after resection of a superficial malignant soft tissue tumor
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作者 Akio Sakamoto Takashi Noguchi Shuichi Matsuda 《World Journal of Clinical Oncology》 2023年第11期471-478,共8页
BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical f... BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical field extension of soft tissue sarcomas.METHODS Grading system:CD-grading is a description system consisting of C and D values in the surgical field extension,which are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.C1/D1 are positive values and C0/D0 are negative.With a known location,1/0 values can be"p"(proximal),"d"(distal),and"b"(in the tumor bed),and the description method is as follows:flap type,CxDx[x=0,1,p,d or b].RESULTS Four representative patients with subcutaneous sarcomas who underwent reconstruction using fasciocutaneous flaps are presented.The cases involved a distal upper arm(elbow)synovial sarcoma reconstructed using a pedicled latissimus dorsi(pedicled flap:CpDp);a distal upper arm(elbow)pleomorphic rhabdomyosarcoma reconstructed using a transpositional flap from the forearm(transpositional flap:CdD0);an undifferentiated pleomorphic sarcoma in the buttocks reconstructed using a transpositional flap(transpositional flap:C0D0);and a myxofibrosarcoma in the buttocks reconstructed using a propeller flap from the thigh(pedicled flap:CdDd).CONCLUSION The reconstruction method is chosen by the surgeon based on size,location,and other tumor characteristics;however,the final surgical field cannot be determined based on preoperative images alone.CD-grading is a description system consisting of C and D values in the surgical field extension that are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.The CD-grading system gives a new perspective to the flap reconstruction classification.The CD-grading system also provides important information for follow-up imaging of a possible recurrence. 展开更多
关键词 Soft tissue SARCOMA Surgery SARCOMA Grading system surgical flap
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When the Combination of a Chinese Flap and Dufourmentel Makes It Possible to Treat a Hopeless Case of Squamous Cell Carcinoma of the Upper Lip
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作者 Silly Toure Abibou Ndiaye +3 位作者 Mouhamadou Makhtar Ndiaye Mamadou Coume Mame Sanou Diouf Baye Karim Diallo 《Open Journal of Stomatology》 2024年第7期327-335,共9页
Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of con... Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap. 展开更多
关键词 surgical flap Reconstruction AESTHETIC Lip Cancer-Plastic Surgery
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Surgical Flap and Graft Reconstruction Workshop for Dermatology Residents
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作者 Brandon Goodwin Richard Wagner 《Journal of Cosmetics, Dermatological Sciences and Applications》 2015年第2期86-93,共8页
Background: Traditional models for teaching surgical principles focus primarily on the apprenticeship theory;however there has been a trend in surgical education to certifying competency in a simulation environment pr... Background: Traditional models for teaching surgical principles focus primarily on the apprenticeship theory;however there has been a trend in surgical education to certifying competency in a simulation environment prior to working with patients. Many surgical models emphasize learning the technical and manual dexterity skills necessary to be a surgeon, yet few focus on obtaining the theoretical and abstract skills needed for planning complex cutaneous surgical repairs with flaps and grafts. We developed and evaluated a novel surgical flaps and grafts workshop for residents through the Department of Dermatology. Methods: Participants received a 60 minute PowerPoint lecture focusing on the basic principles of cutaneous repair with flaps and grafts, with examples and explanation of each of the four main types of flaps and grafts. The participants then received nine photocopies of Mohs micrographic surgery defects with instructions to design three repairs, focusing on functional and aesthetic outcome. Hypothetical and actual repair designs were then discussed in an open forum format. Anonymous surveys administered to 11 dermatology residents assessed their knowledge level, confidence level, and likelihood of using flaps and grafts pre- and post-workshop using Likert scales. Overall experience was also assessed. A paired sample Wilcoxon Signed Rank Test was used for analysis, since the data was non-parametrically distributed. Results: There was a statistically significant increase in confidence performing flaps post workshop (p = 0.0469). There was also an increase in knowledge of flaps and grafts, confidence in planning flaps and grafts, and confidence in performing grafts post workshop, but these findings did not reach statistical significance. The workshop had no effect on expected future use of flaps and grafts. Conclusions: The surgical workshop is a novel simulation teaching tool for learning basic principles and design of flaps and grafts in cutaneous surgery. 展开更多
关键词 “Dermatology” Grafts” flaps surgical Skills Workshop” “Resident Education”
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Surgical treatment of anal stenosis 被引量:25
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作者 Giuseppe Brisinda Serafino Vanella +4 位作者 Federica Cadeddu Gaia Marniga Pasquale Mazzeo Francesco Brandara Giorgio Maria 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第16期1921-1928,共8页
Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of stu... Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classification of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely difficult to interpret the results of the various anoplastic procedures described in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms. 展开更多
关键词 Anal canal surgery Anal stenosis ANOPLASTY HEMORRHOIDECTOMY COMPLICATIONS Lateral internal sphincterotomy surgical flap
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Nasal sill reconstruction with the Abbe flap after skin cancer resection:A case report
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作者 Renata Fernanda Ramos Marcante Oona Tomiê Daronch +1 位作者 Murilo Sgarbi Secanho Maria Madalena Silva 《Chinese Journal of Plastic and Reconstructive Surgery》 2023年第2期64-67,共4页
Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For... Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For larger defects,greater tissue mobilization with larger scars or free flaps is required.Historically,the Abbe flap has been used for lip reconstruction in patients with cleft lip deformities.It allows less retraction than other local flaps or skin grafts in patients with large defect sizes and great defect depths.This study reported on the application of the Abbe flap for nasal sill reconstruction on a 71-year-old female patient with nasal sill basal cell carcinoma who had undergone resection surgery with a posterior lip switch operation with satisfactory results.The application of the Abbe flap could be considered in patients with multiple previous surgeries and at risk for necrosis. 展开更多
关键词 surgical flaps Myocutaneous flap NOSE Nasal diseases Nasal defects NEOPLASMS Basal cell
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Measurement of combined flap thickness for reconstruction of decubitus ulcer using computed tomography
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作者 Eun Chan Kim Jeong Do Park +1 位作者 Syeo-Young Wee Se-Young Kim 《World Journal of Clinical Cases》 SCIE 2023年第31期7562-7569,共8页
BACKGROUND Various reconstruction options have been introduced to treat decubitus ulcers.A combined flap that takes advantage of the fasciocutaneous and muscle flaps has been proven to be effective in reconstructing d... BACKGROUND Various reconstruction options have been introduced to treat decubitus ulcers.A combined flap that takes advantage of the fasciocutaneous and muscle flaps has been proven to be effective in reconstructing decubitus ulcers in previous studies.However,no studies have measured combined flap thickness.This is the first study to demonstrate the superiority of the combined flap by measuring its thickness using enhanced abdominopelvic computed tomography(APCT).AIM To evaluate combined flap modality as a useful reconstruction option for decubitus ulcers using measurements obtained through APCT.METHODS Fifteen patients with paraplegia who underwent combined flap surgery for reconstruction of decubitus ulcers between March 2020 and December 2021 were included.The defects in the skin and muscle components were reconstructed separately.The inner gluteus muscle flap was split and manipulated to obliterate dead space.The outer fasciocutaneous flap was transposed to cover the muscle flap and opening of the decubitus ulcer.Subsequently,we performed enhanced APCT at 3 wk and 6 mo postoperatively to measure the flap thickness.RESULTS The mean flap thickness was 32.85±8.89 mm at 3 wk postoperatively and 29.27±8.22 mm at 6 mo postoperatively.The flap thickness was maintained without any major complications such as contour deformities or recurrence.CONCLUSION Although there was a significant decrease in flap thickness as measured by APCT,the combined flap provided sufficient padding and maintained its thickness even at 6 mo after reconstruction,suggesting that the combined flap modality may be a useful reconstruction option for patients with paraplegic decubitus ulcers. 展开更多
关键词 Computed tomography Decubitus ulcer ISCHIUM surgical flaps Trochanter
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Does the advantage of transcutaneous oximetry measurements in diabetic foot ulcer apply equally to free flap reconstruction?
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作者 Da Woon Lee Yong Seon Hwang +2 位作者 Je Yeon Byeon Jun Hyuk Kim Hwan Jun Choi 《World Journal of Clinical Cases》 SCIE 2023年第31期7570-7582,共13页
BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2... BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not. 展开更多
关键词 Arteriovenous shunt surgical Diabetic neuropathies Free tissue flaps SYMPATHECTOMY Blood gas monitoring TRANSCUTANEOUS Diabetic angiopathies
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Nasolabial perforator flap for nasal defects
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作者 Hongying Lin Guanhuier Wang +2 位作者 Yonghuan Zhen Youbai Chen Yang An 《Chinese Journal of Plastic and Reconstructive Surgery》 2023年第1期33-38,共6页
Nasal defects can be reconstructed with a nasolabial perforator flap,resulting in good aesthetic outcomes based on the facial subunit principle,owing to the combined advantages of the traditional nasolabial flap and t... Nasal defects can be reconstructed with a nasolabial perforator flap,resulting in good aesthetic outcomes based on the facial subunit principle,owing to the combined advantages of the traditional nasolabial flap and the perforator flap.However,the localization of perforators makes the clinical application of a nasolabial perforator flap difficult.This review aims to provide a comprehensive summary of the nasolabial perforator flap from anatomical,methodological,and clinical application aspects,intending to provide plastic surgeons with a reference on conducting nasal reconstruction with a nasolabial perforator flap. 展开更多
关键词 Perforator flap Nasal reconstruction ANATOMY surgical flap
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头戴式手术录像系统在游离皮瓣修复重建手术教学中的应用
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作者 程辰 程开祥 +1 位作者 邵静 刘阳 《组织工程与重建外科》 CAS 2024年第4期500-502,共3页
目的探讨头戴式手术录像系统应用于游离皮瓣修复重建手术的教学效果。方法纳入2022年6月至2023年12月在上海第九人民医院整复外科进行进修学习的进修医生45名,随机分为试验组(n=23)和对照组(n=22)。两组均采用术前小讲课教授基础理论知... 目的探讨头戴式手术录像系统应用于游离皮瓣修复重建手术的教学效果。方法纳入2022年6月至2023年12月在上海第九人民医院整复外科进行进修学习的进修医生45名,随机分为试验组(n=23)和对照组(n=22)。两组均采用术前小讲课教授基础理论知识和手术步骤。手术内容上试验组通过手术录像观摩,录像直接取自手术者的头戴式录像装置并配以解说,而对照组采用传统室内手术观摩的方式。比较两组学员的基本理论考核、手术步骤考核成绩和教学满意率。结果试验组手术步骤考核成绩和教学满意率均高于对照组,差异有统计学意义(P<0.05),而基本理论考核成绩两组差异无统计学意义(P>0.05)。结论头戴式微型摄像系统教学能明显提高学员对于皮瓣重建手术的学习效果并提升教学满意度,具有一定的推广意义。 展开更多
关键词 游离皮瓣 手术录像 临床教学 修复重建 教学满意率
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带胫骨的胫后动脉逆行岛状皮瓣修复足部复合组织缺损
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作者 邱俊涛 路闯 +4 位作者 袁野 李辉 李高辉 刘冲 姚刘永 《实用手外科杂志》 2024年第3期334-336,共3页
目的探讨带胫骨的胫后动脉穿支嵌合皮瓣逆行转移修复足部复合组织缺损的临床效果。方法2013年6月-2020年3月,采用带胫骨的胫后动脉穿支嵌合皮瓣逆行转移修复足部复合组织缺损创面10例,术后对皮瓣外形满意度,痛觉、触觉、温度觉、两点分... 目的探讨带胫骨的胫后动脉穿支嵌合皮瓣逆行转移修复足部复合组织缺损的临床效果。方法2013年6月-2020年3月,采用带胫骨的胫后动脉穿支嵌合皮瓣逆行转移修复足部复合组织缺损创面10例,术后对皮瓣外形满意度,痛觉、触觉、温度觉、两点分辨觉及患肢功能行AOFAS评分。结果术后10例皮瓣全部成活,供区植皮成活良好,伤口一期愈合,胫前供区外形重塑良好。8例获得1~2年的随访,2例因是外地患者失访。皮瓣具有较好的外形,伤口一期愈合,移植骨与受区骨质愈合良好,供区胫骨外形重塑良好,皮瓣无瘢痕增生,无骨髓炎发生,患者对皮瓣外形及足部功能均表示满意,术后1年皮瓣两点分辨觉平均为(10.2±2.1)mm,感觉评级为S3+,根据美国踝-足部AOFAS评分平均为90.8分。结论带胫骨的胫后动脉穿支嵌合皮瓣手术操作简单、血供可靠、供区影响小足部功能恢复好、外形满意,是修复足部复合组织缺损一种可供选择的方法。 展开更多
关键词 外科皮瓣 穿支嵌合皮瓣 复合组织修复 胫后动脉
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改良拇指桡背侧皮神经营养血管皮瓣在拇指缺损重建中的应用
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作者 刘宗义 荣向科 +3 位作者 刘士强 宋永斌 徐春娟 石定 《创伤外科杂志》 2024年第6期452-455,共4页
目的探讨改良拇指桡背侧皮神经营养血管皮瓣在拇指缺损重建的手术方法和临床效果。方法回顾性分析2019年4月—2022年8月中国人民解放军联勤保障部队第九八七医院烧伤整形显微外科收治拇指末节离断伤无法再植或者再植失败患者7例,男性6例... 目的探讨改良拇指桡背侧皮神经营养血管皮瓣在拇指缺损重建的手术方法和临床效果。方法回顾性分析2019年4月—2022年8月中国人民解放军联勤保障部队第九八七医院烧伤整形显微外科收治拇指末节离断伤无法再植或者再植失败患者7例,男性6例,女性1例;年龄20~51岁,平均39.4岁;左手4例,右手3例;挤轧伤5例,切割伤2例;因指体毁损严重无法再植4例,再植失败后行皮瓣修复3例。剔除离断指体近端的坏死组织后保留指骨,采用、改良大面积拇指桡背侧皮神经营养血管皮瓣包裹外露指骨重建拇指末节,供区行植皮覆盖。出院后随访皮瓣外观、感觉,以及供区和手功能恢复情况。结果患者缺损面积为2.5 cm×4.5 cm~3.0 cm×6.0 cm,皮瓣切取面积为2.5 cm×5.0 cm~3.5 cm×6.5 cm。7例皮瓣全部存活,供区植皮全部成活。术后随访3~20个月,平均4.6个月。术后3个月,皮瓣外形饱满,无臃肿,质地满意,感觉初步建立。根据中华医学会手外科分会上肢部分功能评定试用标准评价手指功能:优5例,良1例,可1例,差1例,优良率85.7%。结论经改良后进一步将拇指桡背侧皮神经营养血管皮瓣切取面积扩大,包裹外露指骨重建拇指末节,皮瓣血运可靠,手术操作简便、成功率高,供区损伤小,临床效果满意,值得推广。 展开更多
关键词 指损伤 创面修复 外科皮瓣拇指 指骨
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远端蒂腓肠神经营养血管皮瓣修复足跟部软组织缺损的疗效 被引量:3
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作者 李海义 刘志功 陈克俊 《临床骨科杂志》 2024年第1期47-51,共5页
目的探讨远端蒂腓肠神经营养血管皮瓣修复足跟部软组织缺损的临床疗效。方法采用远端蒂腓肠神经营养血管皮瓣修复25例足跟部软组织缺损患者,均经明道转移皮瓣至受区。缺损面积4.2 cm×3.6 cm~9.5 cm×7.0 cm;皮瓣设计面积5.0 cm... 目的探讨远端蒂腓肠神经营养血管皮瓣修复足跟部软组织缺损的临床疗效。方法采用远端蒂腓肠神经营养血管皮瓣修复25例足跟部软组织缺损患者,均经明道转移皮瓣至受区。缺损面积4.2 cm×3.6 cm~9.5 cm×7.0 cm;皮瓣设计面积5.0 cm×4.2 cm~11.5 cm×8.4 cm。结果患者均获得随访,时间11~38个月。皮瓣均成活,供区一期愈合。术后3个月皮瓣外观色泽良好,质地柔软,对正常穿鞋无影响,未出现磨损溃疡,患者满意度较高。结论远端蒂腓肠神经营养血管皮瓣修复足跟部软组织缺损,具有解剖相对恒定、手术操作简单、不牺牲主要动脉、皮瓣易成活的优势。 展开更多
关键词 足损伤 软组织缺损 腓肠神经 外科皮瓣
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指端软组织缺损皮瓣修复术后捏力的影响因素研究进展 被引量:2
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作者 贾鑫玮 艾佳慧 +4 位作者 刘纯 邓凯 王红涛 张一晗 王辉 《创伤外科杂志》 2024年第1期67-71,共5页
手外伤常导致指端软组织缺损,各种外科皮瓣常成为其修复的重要术式。指端软组织的修复与重建是伤指捏力恢复的基础。捏力的恢复是手功能重建的重要部分,影响人们精细活动与日常生活。但关于皮瓣修复术后对伤指捏力的影响,相关研究较少... 手外伤常导致指端软组织缺损,各种外科皮瓣常成为其修复的重要术式。指端软组织的修复与重建是伤指捏力恢复的基础。捏力的恢复是手功能重建的重要部分,影响人们精细活动与日常生活。但关于皮瓣修复术后对伤指捏力的影响,相关研究较少。本文总结并分析了皮瓣质地、皮瓣内触觉小体、吻合神经及皮瓣感觉、术后疼痛、心理因素等相关因素对皮瓣修复指端软组织缺损术后捏力的影响,旨在为术后伤指捏力恢复的临床研究与康复提供一定参考。 展开更多
关键词 手指损伤 外科皮瓣 捏力 影响因素
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上颌正中埋伏多生牙拔除入路选择的临床研究
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作者 叶虎 翟沁凯 +2 位作者 郝新河 许晓波 韩爽 《安徽医科大学学报》 CAS 北大核心 2024年第5期909-913,共5页
目的探求拔除上颌正中埋伏多生牙采取单侧翻瓣和改变手术计划为双侧翻瓣的相关因素。方法回顾性分析拔除上颌正中埋伏多生牙的81例患者。主要结果变量是:计划手术(单侧翻瓣)和计划外手术(双侧翻瓣)。次要结果变量是:手术时间和术后肿胀... 目的探求拔除上颌正中埋伏多生牙采取单侧翻瓣和改变手术计划为双侧翻瓣的相关因素。方法回顾性分析拔除上颌正中埋伏多生牙的81例患者。主要结果变量是:计划手术(单侧翻瓣)和计划外手术(双侧翻瓣)。次要结果变量是:手术时间和术后肿胀程度。预测变量为:多生牙距离唇侧和腭侧骨板的最短距离差值,分为差值≥1.5 mm组和<1.5 mm组;邻牙根尖至鼻底距离与多生牙长径比值,记录为≥1和<1。采用SPSS 20统计软件完成统计学分析。结果距离差值<1.5 mm时,计划外手术可能性增大,计划手术的概率是计划外手术概率的0.085倍;年龄每增加1岁,计划手术的概率逐步降低,HR=0.745;腭侧入路术后肿胀仅为唇侧入路的0.374倍;随着年龄的增加其手术时间有逐渐增加趋势,B=1.213。邻牙根尖至鼻底距离与多生牙长径比值并未影响到术中手术计划改变。结论多生牙距离唇侧和腭侧骨板的最短距离差值可作为拔除上颌正中埋伏多生牙选择手术入路的参考依据。 展开更多
关键词 正中多生牙 单双侧翻瓣 手术入路 拔牙
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不同皮瓣重建上唇缺损美学亚单位术后疗效的系统评价
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作者 张林祥 苟学立 +4 位作者 韩骐泽 岳海泉 杨馨 张宝平 刘瑞敏 《兰州大学学报(医学版)》 2024年第9期52-59,69,共9页
目的收集国内、外因外伤、瘢痕二次修复及肿瘤切除术后导致上唇缺损的队列研究,通过系统评价方法研究不同皮瓣修复术后并发症与美学功能恢复,为临床重建上唇提供循证学证据。方法计算机检索中国知识基础设施工程数据库、万方数据库、维... 目的收集国内、外因外伤、瘢痕二次修复及肿瘤切除术后导致上唇缺损的队列研究,通过系统评价方法研究不同皮瓣修复术后并发症与美学功能恢复,为临床重建上唇提供循证学证据。方法计算机检索中国知识基础设施工程数据库、万方数据库、维普中文期刊数据库、PubMed、The Cochrane Library、Embase和Web of Science等国内外多个数据库。搜索从建库到2023年9月1日关于不同类型皮瓣修复上唇缺损的研究。经2位研究人员独立筛选,从筛选数据中获得有价值的信息,并选择非随机化研究方法学指数的方法,全面检验其结果的可靠性和可信度。参照上唇美学亚单位重建的基础,对各类皮瓣修复的优、缺点归纳总结,探讨其临床应用价值。结果最终纳入21篇回顾性队列研究,1篇病例系列。其中包含3类修复方式,第1类是局部皮瓣,包括推进(V-Y、A-T、O-L)皮瓣、菱形皮瓣、Z成形术、鼻唇沟皮瓣;第2类是游离皮瓣,如前臂游离皮瓣、股前外侧皮瓣;第3类是带蒂皮瓣,包括交叉唇(Abbe-Estlander)瓣、岛状皮瓣等。结论涉及一个美学亚单位的上唇缺损修复方法以局部皮瓣为主,而上唇大面积全层缺损或涉及两个美学亚单位重建时,多采用带蒂或游离皮瓣修复。 展开更多
关键词 上唇重建 美学 皮瓣 定性研究 系统评价 上唇 缺损修复
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近、中节指动脉背侧支血管链皮瓣修复指端缺损的疗效比较
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作者 贾鑫玮 艾佳慧 +4 位作者 刘纯 邓凯 王红涛 张一晗 王辉 《临床骨科杂志》 2024年第3期350-353,共4页
目的比较近、中节指动脉背侧支血管链皮瓣修复指端缺损的临床疗效。方法将46例指端缺损患者根据皮瓣位置不同分为近节供区组(采用近节指动脉背侧支血管链皮瓣修复,24例)和中节供区组(采用中节指动脉背侧支血管链皮瓣修复,22例)。比较两... 目的比较近、中节指动脉背侧支血管链皮瓣修复指端缺损的临床疗效。方法将46例指端缺损患者根据皮瓣位置不同分为近节供区组(采用近节指动脉背侧支血管链皮瓣修复,24例)和中节供区组(采用中节指动脉背侧支血管链皮瓣修复,22例)。比较两组伤指关节屈曲活动度、静态和动态两点辨别觉、寒冷不耐受症状严重程度量表评分、单丝测试、疼痛VAS评分。结果患者均获得随访,时间12~20个月。两组皮瓣及移植皮片均成活,供区均一期愈合,皮瓣均无明显冗余、回缩、色素沉着,质地良好。末次随访时,伤指关节屈曲活动度、寒冷不耐受症状严重程度量表评分两组比较差异均无统计学意义(P>0.05);静态和动态两点辨别觉、单丝测试中节供区组均小于近节供区组(P<0.05);疼痛VAS评分中节供区组低于近节供区组(P<0.05)。结论与近节供区相比,中节指动脉背侧支血管链皮瓣修复指端缺损,指端感觉功能恢复更好。 展开更多
关键词 外科皮瓣 指动脉背侧支血管链皮瓣 指端缺损 感觉重建
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下肢严重开放性损伤创面修复的研究进展 被引量:1
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作者 沈华清 王东方 +1 位作者 尹恩志 廖忆刘 《临床外科杂志》 2024年第2期216-218,共3页
下肢严重开放性损伤病情复杂,难以短期治愈,可导致严重感染、截肢等。对于开放性损伤治疗,创面修复极为重要。多种新技术如新型敷料、富血小板血浆(Platelet-rich plasma, PRP)、负压封闭引流技术(vacuum sealing drainage, VSD)等近来... 下肢严重开放性损伤病情复杂,难以短期治愈,可导致严重感染、截肢等。对于开放性损伤治疗,创面修复极为重要。多种新技术如新型敷料、富血小板血浆(Platelet-rich plasma, PRP)、负压封闭引流技术(vacuum sealing drainage, VSD)等近来被应用于下肢创面修复,既能改善功能预后与美观效果,又能提升创面愈合质量。本综述将总结下肢开放性损伤创面修复方式的研究进展,以进一步指导临床应用。 展开更多
关键词 外科皮瓣 负压封闭引流技术 富血小板血浆 创面修复
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二次龈下刮治术和根面平整术与改良威德曼翻瓣术治疗牙周炎的临床疗效
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作者 董小倩 王海芹 +2 位作者 李文璐 周东升 郭鲁燕 《当代医学》 2024年第16期106-109,共4页
目的探讨二次龈下刮治术和根面平整术(scaling and root planing,SRP)与改良威德曼翻瓣术治疗牙周炎的临床疗效。方法选取2019年7月至2022年3月菏泽市立医院口腔科收治的57例慢性牙周炎患者作为研究对象,按照分口设计原则所有患者的同... 目的探讨二次龈下刮治术和根面平整术(scaling and root planing,SRP)与改良威德曼翻瓣术治疗牙周炎的临床疗效。方法选取2019年7月至2022年3月菏泽市立医院口腔科收治的57例慢性牙周炎患者作为研究对象,按照分口设计原则所有患者的同颌对称同名牙随机分为翻瓣组与二次SRP组,其中每组单根牙(前牙48颗,前磨牙9颗)57颗,多根牙(磨牙57颗)57颗,每组114颗牙。两组均行牙周基础治疗,翻瓣组行改良威德曼翻瓣术治疗,二次SRP组行SRP治疗。比较两组单根牙、多根牙治疗前、治疗后6个月探诊深度(probing depth,PD)、牙龈退缩(gingival recession,GR)、临床附着丧失(clinical attachment loss,CAL)、龈沟出血指数(gingival sulcus bleeding index,SBI)、菌斑指数(plaque index,PLI)及牙槽骨吸收情况。结果治疗后,两组单根牙PD均浅于治疗前,CAL均短于治疗前,SBI、PLI均低于治疗前,翻瓣组GR长于治疗前,但二次SRP组GR短于翻瓣组,差异有统计学意义(P<0.05)。治疗后,两组多根牙PD均浅于治疗前,GR、CAL均短于治疗前,SBI、PLI均低于治疗前,但二次SRP组GR短于翻瓣组,差异有统计学意义(P<0.05)。两组单根牙、多根牙术后控制牙槽骨吸收有效率比较差异无统计学意义。结论二次SRP与改良威德曼翻瓣术治疗单根牙和未累及根分叉的多根牙的牙周炎疗效相当,但二次SRP治疗后GR改善更明显,且二次SRP操作相对简单,损伤更小,更易于被患者接受,值得临床推广应用。 展开更多
关键词 改良威德曼翻瓣术 二次龈下刮治术和根面平整术 牙周炎 牙周基础治疗
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带蒂股前外侧穿支皮瓣移植术修复儿童臀部硬纤维瘤切除后皮肤软组织缺损1例并文献分析
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作者 王军 曾凌嵘 +2 位作者 伍江雁 谭晓谦 梅海波 《临床小儿外科杂志》 CAS CSCD 北大核心 2024年第3期273-278,共6页
目的结合文献探讨带蒂股前外侧穿支皮瓣移植术修复臀部硬纤维瘤切除后皮肤软组织缺损的疗效。方法回顾性分析湖南省儿童医院骨科2020年11月收治的1例臀部硬纤维瘤患儿临床资料,收集肿块情况以及肿块切除后皮肤软组织缺损大小、带蒂股前... 目的结合文献探讨带蒂股前外侧穿支皮瓣移植术修复臀部硬纤维瘤切除后皮肤软组织缺损的疗效。方法回顾性分析湖南省儿童医院骨科2020年11月收治的1例臀部硬纤维瘤患儿临床资料,收集肿块情况以及肿块切除后皮肤软组织缺损大小、带蒂股前外侧穿支皮瓣修复后皮瓣存活情况以及髋关节功能。以"pedicled anterolateral perforator thigh flap"、"soft tissue defect of hip"为检索词,检索PubMed数据库相关英文文献;以"带蒂股前外侧皮瓣"、"臀部皮肤软组织缺损"为检索词,检索中国知网、万方数据库中相关中文文献;检索时间自1970年1月至2022年12月,排除综述、信件、会议摘要后进行文献复习。结果本例患儿臀部硬纤维瘤大小15 cm×8 cm×6 cm,手术后臀部皮肤软组织缺损大小15 cm×6.5 cm,切取带蒂股前外侧穿支皮瓣大小15 cm×6.5 cm,采取供区直接缝合,受区无需植皮,术后皮瓣存活,未见血管危象;出院后随访24个月,臀部硬纤维瘤未见复发,供区愈合良好;无肌疝,受区皮瓣颜色、质地良好,患肢髋、膝关节活动未见受限。共检索到符合纳入标准的文献2篇,均为个案报道,共2例带蒂股前外侧穿支皮瓣移植修复臀部软组织缺损,均为男性,1例采用双侧带蒂股前外侧穿支皮瓣移植,皮瓣大小分别为35 cm×8 cm和22 cm×7 cm;另外1例切取大小29 cm×20 cm,受区部分植皮;2例术后随访皮瓣均存活,皮瓣质地良好,未见髋关节活动受限。结论带蒂股前外侧穿支皮瓣移植修复臀部皮肤软组织缺损是一种有效、可行的治疗方法。 展开更多
关键词 硬纤维瘤 带蒂股前外侧皮瓣 皮瓣转位 外科手术 儿童
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颏下岛状皮瓣在保留喉功能的下咽癌手术中应用
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作者 吴麟 罗伟 +7 位作者 江满杰 许莉 陈伟 施涛 季俊峰 刘厚军 王志颐 相芳 《中国中西医结合耳鼻咽喉科杂志》 2024年第4期279-282,共4页
目的探讨颏下岛状皮瓣在保留喉功能的下咽癌手术中的应用。方法回顾分析30例梨状窝癌行保留喉功能下咽肿瘤切除颏下岛状皮瓣修复的综合治疗的临床资料。结果30例患者行手术患者,利用颏下岛状皮瓣在保留喉功能行下咽癌切除术中缺损进行修... 目的探讨颏下岛状皮瓣在保留喉功能的下咽癌手术中的应用。方法回顾分析30例梨状窝癌行保留喉功能下咽肿瘤切除颏下岛状皮瓣修复的综合治疗的临床资料。结果30例患者行手术患者,利用颏下岛状皮瓣在保留喉功能行下咽癌切除术中缺损进行修复,术后颏下皮瓣均成活,其中4例皮瓣术后局部瘀血部分坏死,皮瓣延迟愈合;无1例咽漏发生;全部患者恢复经口饮食时间为术后34±11d;全部患者拔气管导管时间为术后93±21d。30例患者中,单纯手术5例,术后放疗7例,放疗+化疗18例。患者随访时间10~78个月,失访3例。本组病例术后生存曲线,2、3、5年生存率分别为75.3%、50.8%、43.7%;局部复发伴淋巴结转移8例;肺转移癌6例;食管癌4例;无瘤生存者16例;带瘤生存者7例;死亡4例。结论颏下岛状皮瓣修复下咽肿瘤切除后的缺损,具有皮肤组织量较大,血供确切,抗感染能力强,制作相对简单等诸多优点,适合梨状窝癌半喉侵犯行喉功能保留肿瘤切除术,严格把握适应证,提高患者生活质量。 展开更多
关键词 下咽肿瘤 喉功能 外科皮瓣 外科手术 颏下瓣
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