Objective： The aim of this study was to evaluate the value of the application of anterolateral thigh flap in postoperative repairing of vulva tumor. Methods： Anterolateral thigh flap with the descending branch of th...Objective： The aim of this study was to evaluate the value of the application of anterolateral thigh flap in postoperative repairing of vulva tumor. Methods： Anterolateral thigh flap with the descending branch of the lateral circumflex femoral artery and the pedicle of anterolaterat thigh cutaneous nerve was used in primary repairing of the defect from postoperative vulva tumor, the sizes of the flaps ranged from 10 cm ×14 cm-14 cm× 20 cm. Results： All flaps survived, during a follow-up of 2 to 12 months, the appearance of the flaps was satisfactory with sensitive function without local recurrences. Conclusion： Anterelateral thigh flap has fairly long vessel pedicle, wider vessel diameter, and is in the covert area. Anterolateral thigh flap with sensory nerve is the ideal choice for postoperative repairing of vulva tumor.展开更多
Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor sit...Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.Methods：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps.Afterwards,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.Results：All six free scapular flaps survived without signs of infection.Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative therapy.All the incisions healed without other complications.At six-month follow-up,the patients regained full shoulder function.Conclusion：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar.It can achieve positive outcomes in both reconstructive and aesthetic aspects.展开更多
Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period. Methods: Twenty-two flap reconstructions were performed to treat soft-tissue de...Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period. Methods: Twenty-two flap reconstructions were performed to treat soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively after follow up of 12-61 months. Results: The size of the flap ranged from 6.6 cm 2 to 28.18 cm 2 and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series. Conclusions: For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are ① to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; ② to select a unilateral external fixation to provide convenience for any secondary manipulation; and ③ to use serial debridement to diminish flap failure.展开更多
The tracheocutaneous fistula after tracheostomy is a complex clinical problem. An ideal fistula closure is still difficult at present though a variety of fistula-closing methods have been reported in the literature. W...The tracheocutaneous fistula after tracheostomy is a complex clinical problem. An ideal fistula closure is still difficult at present though a variety of fistula-closing methods have been reported in the literature. We used a turnover skin flap to cover the fistula. All the procedures were completed at bedside under local anesthesia. The fistula was successfully closed and well healed without complications within 7-9 days. It has been proven that this operation is simple, effective, and safe.展开更多
Objective: To observe the revascularization and the opportunity of cross finger flap. Methods: An animal model was developed to permit daily monitoring of neovascularization of the flap with autoradiography, tissue tr...Objective: To observe the revascularization and the opportunity of cross finger flap. Methods: An animal model was developed to permit daily monitoring of neovascularization of the flap with autoradiography, tissue transparent technique, gross observation and histological examination. Results: The revascularization of the flap was chiefly raised from the surrounding tissues. The pedicles of 334 cross finger flaps of the patients were successfully divided from 1 to 5 d after operations, averagely 3.3 d. All of the cases showed satisfatory results according to a follow up survey of 3 to 72 mon. The results further proved that the revascularization of the cross finger flaps had accomplished within 3 d. Conclusions: It suggests that the division of a cross finger flap can be carried out between the 3rd and 5th day after operation with a high degree of safety.展开更多
A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de- fect （27 cmx7 cm）. Doppler examination revealed the ...A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de- fect （27 cmx7 cm）. Doppler examination revealed the poste- rior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dots myocutaneous flap was elevated with a T-shaped vascular pedicle and was in- terposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anasto- moses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap＇s T-shaped vascularpedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap sur- vived completely. After 3-years＇ follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery ofcontralateral leg was demonstrated patent by clinical and Doppler examinations.展开更多
A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolu...A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cmx4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap＇s vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap＇s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.展开更多
文摘Objective： The aim of this study was to evaluate the value of the application of anterolateral thigh flap in postoperative repairing of vulva tumor. Methods： Anterolateral thigh flap with the descending branch of the lateral circumflex femoral artery and the pedicle of anterolaterat thigh cutaneous nerve was used in primary repairing of the defect from postoperative vulva tumor, the sizes of the flaps ranged from 10 cm ×14 cm-14 cm× 20 cm. Results： All flaps survived, during a follow-up of 2 to 12 months, the appearance of the flaps was satisfactory with sensitive function without local recurrences. Conclusion： Anterelateral thigh flap has fairly long vessel pedicle, wider vessel diameter, and is in the covert area. Anterolateral thigh flap with sensory nerve is the ideal choice for postoperative repairing of vulva tumor.
文摘Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.Methods：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps.Afterwards,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.Results：All six free scapular flaps survived without signs of infection.Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative therapy.All the incisions healed without other complications.At six-month follow-up,the patients regained full shoulder function.Conclusion：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar.It can achieve positive outcomes in both reconstructive and aesthetic aspects.
文摘Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period. Methods: Twenty-two flap reconstructions were performed to treat soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively after follow up of 12-61 months. Results: The size of the flap ranged from 6.6 cm 2 to 28.18 cm 2 and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series. Conclusions: For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are ① to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; ② to select a unilateral external fixation to provide convenience for any secondary manipulation; and ③ to use serial debridement to diminish flap failure.
文摘The tracheocutaneous fistula after tracheostomy is a complex clinical problem. An ideal fistula closure is still difficult at present though a variety of fistula-closing methods have been reported in the literature. We used a turnover skin flap to cover the fistula. All the procedures were completed at bedside under local anesthesia. The fistula was successfully closed and well healed without complications within 7-9 days. It has been proven that this operation is simple, effective, and safe.
文摘Objective: To observe the revascularization and the opportunity of cross finger flap. Methods: An animal model was developed to permit daily monitoring of neovascularization of the flap with autoradiography, tissue transparent technique, gross observation and histological examination. Results: The revascularization of the flap was chiefly raised from the surrounding tissues. The pedicles of 334 cross finger flaps of the patients were successfully divided from 1 to 5 d after operations, averagely 3.3 d. All of the cases showed satisfatory results according to a follow up survey of 3 to 72 mon. The results further proved that the revascularization of the cross finger flaps had accomplished within 3 d. Conclusions: It suggests that the division of a cross finger flap can be carried out between the 3rd and 5th day after operation with a high degree of safety.
文摘A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de- fect （27 cmx7 cm）. Doppler examination revealed the poste- rior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dots myocutaneous flap was elevated with a T-shaped vascular pedicle and was in- terposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anasto- moses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap＇s T-shaped vascularpedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap sur- vived completely. After 3-years＇ follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery ofcontralateral leg was demonstrated patent by clinical and Doppler examinations.
文摘A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cmx4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap＇s vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap＇s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.
