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Versatility of Reverse Sural Fasciocutaneous Flap for Reconstruction of Distal Lower Limb Soft tissue Defects 被引量:3
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作者 潘海涛 郑启新 +2 位作者 杨述华 吴斌 刘建湘 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2014年第3期382-386,共5页
Summary: In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried o... Summary: In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years (14-83 years) and with a medium followp period of 18 months (12-24 months). Of all the cases of acute trauma, there were 10 eases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes (2 cases), advanced age (〉65 years, 3 cases) and ciga- rette smoking (6 cases). The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites. 展开更多
关键词 sural nerve reverse island flap distal lower limb soft tissue defects
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Applied distally based peroneus brevis muscle flaps for coverage of the soft tissue defects over the lower one-third of the leg, ankle and foot
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作者 邓国三 《外科研究与新技术》 2003年第2期128-129,共2页
Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applie... Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applied for coverage of the soft tissue defects over the lower one-third of the leg,the ankle and the foot. The muscle flaps were covered with split-thickness skin grafts. Results The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot in 16 cases. The larges area of the soft tissue defect was 5 cm × 7 cm. The smallest was 3 cm × 4 cm. Primary healing occured in 14 cases undergoing muscle flap construction, second-stage healing occured in 2 cases, no total flap necrosis occured in any cases. Conclusion ThisChina Medical Abstracts(Surgery) technigue is a simple and complication are lesser. The successful rates are higher. This muscle flap is suitable to the mudium or small soft tissue 展开更多
关键词 of Applied distally based peroneus brevis muscle flaps for coverage of the soft tissue defects over the lower one-third of the leg ankle and foot
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Experimental study on early repair of oromaxillofacial perforating soft tissue defect due to gunshot in dogs
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作者 李慧增 孙远 +3 位作者 刘荫秋 史文进 容国俊 周宝桐 《Journal of Medical Colleges of PLA(China)》 CAS 1993年第2期148-151,共4页
The left cheek of 8 adult male mongrel dogs was shot with M1935.56mm bul-let fired through an US-made M16 rifle to result in a perforating soft tissue defect.Pri-mary debridement was performed immediately and the seco... The left cheek of 8 adult male mongrel dogs was shot with M1935.56mm bul-let fired through an US-made M16 rifle to result in a perforating soft tissue defect.Pri-mary debridement was performed immediately and the secondary debridement 72h alter in-jury.After the secondary thorough debridement,the cutaneous side of the defect was re-paired with a saphenous artery-vein free skin(muscular)flap using microvascularanastomosis,and the oral side of the defect was repaired by drawing the surroundingmucosa together and fixing with sutures or with a local sliding mucous membrane flap.All the animals were kept under observation for 2~6 months.It was believed that the pri-mary debridement and secondary thorough debridement were both essential. The survivalrate of the free tissue flap was 75%(6/8).These facts suggest that early repair ofthe oromaxillofacial perforating soft tissue defect due to gunshot is practicable. 展开更多
关键词 oromaxillofacial region GUNSHOT INJURY PERFORATING soft tissue defect reconstruction surgery MICROSURGERY
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Lower rotating point nutrient vessels of sural nerve flap with distant pedicled repairing soft tissue defect of foot and ankle
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作者 林松庆 《外科研究与新技术》 2005年第3期175-176,共2页
To explore lower rotating potint nutrient vessels of sural nerve flap with distant pedicled repairing the soft tissue defect of foot and ankle.Methods Lay a foundation of anatomic studying from february 2003 to March ... To explore lower rotating potint nutrient vessels of sural nerve flap with distant pedicled repairing the soft tissue defect of foot and ankle.Methods Lay a foundation of anatomic studying from february 2003 to March 2004,using lower rotating point nutrient vessels of sural nerve flap with distant pedicled repairing the soft tissue defect of foot and ankle in 11 cases.Cause of injuring:traffic accident 7 cases,crushing 1 case,saw injury 1 case,skin cancer 1 case,chronic ulcer 1 case.Areas:foot heel 6 cases,shank lower section 2 cases,heel tendon 2 cases,the distant back of the foot 1 case.Using the flap axis point was 1~3 cm above the pin of the external heel,average 2 cm.The scope of the flap was 6.0 cm×8.0 cm~12.0 cm~18.0 cm.Results All sural nerve flaps were alive.Of them,2 cases have distant part necrosis,accompanying with subcutaneous tissue,1 case heels after change dressings,another heels after skin grafting.All case can walk as usual,the flap was wear-resisting and keenly feel.Conclusion Lower rotating point nutrient vessels of sural nerve flap,donner area was fine,available area was large,skin in the pink,easy grafting,without main blood vessel damage,survival rate high,it is a good donner area in repairing around heel,foot and shank lower section.7 refs,1 tab. 展开更多
关键词 Lower rotating point nutrient vessels of sural nerve flap with distant pedicled repairing soft tissue defect of foot and ankle
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Oral and maxillofacial-head and neck reconstruction with soft tissue free flaps of 41 cases: A single team's experience 被引量:1
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作者 白岫峰 阿里木江.吾守 +1 位作者 郑军 李刚 《中国美容医学》 CAS 2013年第11期1131-1136,共6页
Objective To retrospectively review the single team's experience of oral and maxillofacialhead and neck reconstruction involving 41 soft tissue free flap procedures.Methods From 1994 to 2012,41 patients who underw... Objective To retrospectively review the single team's experience of oral and maxillofacialhead and neck reconstruction involving 41 soft tissue free flap procedures.Methods From 1994 to 2012,41 patients who underwent oral and maxillofacial-head and neck soft tissue free flap reconstruction at the Department of Oral and Maxillofacial-Head and Neck Surgical Oncology,Hospital and College of Stomatology,Xi'an Jiaotong University,were reviewed with clinicopathologic data.Results The 41 patients included 24 men and 17 women with a mean age of 54 years.A total of 41 soft tissue free flaps were performed to reconstruct different anatomical structures in the head and neck region including oral mucosa,facial bone,head and neck skin.Two types of soft tissue free flaps were used to reconstruct surgical defects,including radial forearm flap and latissimus dorsi myocutaneous flap.Radial forearm flaps were used for 37cases and latissimus dorsi-myocutaneous flaps were 4 cases.Of 41 cases,39 were successful,with an overall success rate of 95.1%.There were 2 free flap failures,including one radial forearm flap and one latissimus dorsi-myocutaneous flap(partial flap necrosis);hence,the flap success rates for radial forearm flap and latissimus dorsimyocutaneous were,respectively,97.3% and 87.5%.Conclusions Radial forearm flap and latissimus dorsi-myocutaneous flap are reliable soft tissue free flaps to repair oral and maxillofacial-head and neck area with high success rate,which resulted in good functionally and cosmetically with fewer complications both donor and recipient sites. 展开更多
关键词 医疗卫生行业 整容 医学美容 皮肤
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Application of a pre-filled tissue expander for preventing soft tissue incarceration during tibial distraction osteogenesis
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作者 Hui Chen Xing Teng +3 位作者 Xiao-Hua Hu Lin Cheng Wei-Li Du Yu-Ming Shen 《World Journal of Clinical Cases》 SCIE 2020年第11期2181-2189,共9页
BACKGROUND Bone transport and distraction osteogenesis has been widely used to treat bone defects after traumatic surgery,but,skin and soft tissue incarceration can be as high as 27.6%.AIM To investigate the efficacy ... BACKGROUND Bone transport and distraction osteogenesis has been widely used to treat bone defects after traumatic surgery,but,skin and soft tissue incarceration can be as high as 27.6%.AIM To investigate the efficacy of inserting a tissue expander to prevent soft tissue incarceration.METHODS Between January 2016 and December 2018,12 patients underwent implantation of a tissue expander in the subcutaneous layer in the vicinity of a tibial defect to maintain the soft tissue in position.A certain amount of normal saline was injected into the tissue expander during surgery and was then gradually extracted to shrink the expander during the course of transport distraction osteogenesis.The tissue expander was removed when the two ends of the tibial defect were close enough.RESULTS In all 12 patients,the expanders remained intact in the subcutaneous layer of the bone defect area during the course of transport distraction osteogenesis.When bone transport was adequate,the expander was removed and the bone transport process was completed.During the whole process,there was no incarceration of skin and soft tissue in the bone defect area.Complications occurred in one patient,who experienced poor wound healing.CONCLUSION The pre-filled expander technique can effectively avoid soft tissue incarceration.The authors’primary success with this method indicates that it may be a valuable tool in the management of incarcerated soft tissue. 展开更多
关键词 tissue expander Tibial defect Bone transport Skin and soft tissue incarceration Distraction osteogenesis
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Effect of a combination of local flap and sequential compression- distraction osteogenesis in the reconstruction of post-traumatic tibial bone and soft tissue defects 被引量:7
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作者 HU Xiao-hua HUANG Lei CHEN Zhong DU Wei-li WANG Cheng SHEN Yu-ming 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第15期2846-2851,共6页
Background Treatment of extensive post-traumatic composite bone and soft tissue defects remains a complicated therapeutic problem and a challenge for surgeons. We investigated the application of local flaps and Ilizar... Background Treatment of extensive post-traumatic composite bone and soft tissue defects remains a complicated therapeutic problem and a challenge for surgeons. We investigated the application of local flaps and Ilizarov osteogenesis in the reestablishment of severe combined defects of tibial bone and soft tissue. Methods Sixteen patients with bone and soft tissue defects were included. The mean age of the patients was 31.5 years. The average time from injury to initial surgery was 14.4 weeks. The average soft tissue and bone defect sizes were 92.9 cm2 and 8.7 cm, respectively. Local flaps were created to reconstruct the soft tissue defects. The Ilizarov external fixator or the Orthofix Limb Reconstruction System was used to reconstruct bony defects using delayed distraction osteogenesis. Results Two myocutaneous flaps and 14 reverse island flaps were applied. All transferred flaps survived. Fifteen patients healed with equal leg length, and one healed with a residual leg-length discrepancy of 1.5 cm. One patient with an Ilizarov external fixator developed ankle joint stiffening and a pin-track infection that was successfully treated with oral antibiotics. No patient developed pin loosening. All patients walked without assistance. Fifteen patients returned to their work, and one lost her job. The results were evaluated using the Paley bone and functional assessment scores. The bone assessment results were excellent in 14 and good in two patients. Functional assessment scores were excellent in 13, good in two, and fair in one patient. Conclusion The combination of local flaps and sequential distraction osteogenesis can be used for successful reconstruction of defects of incorporated bone and soft tissue. 展开更多
关键词 bone defect soft tissue loss treatment local flap compression-distraction osteogenesis
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Reconstruction of post-traumatic upper extremity soft tissue defects with pedicled flaps: An algorithmic approach to clinical decision making 被引量:2
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作者 Ravikiran Naalla Shashank Chauhan +1 位作者 Aniket Dave Maneesh Singhal 《Chinese Journal of Traumatology》 CAS CSCD 2018年第6期338-351,共14页
Purpose:Pedicled flaps are still the workhorse flaps for reconstruction of upper limb soft tissue defects in many centers across the world. They are lifeboat options for coverage in vessel deplete wounds. In spite of ... Purpose:Pedicled flaps are still the workhorse flaps for reconstruction of upper limb soft tissue defects in many centers across the world. They are lifeboat options for coverage in vessel deplete wounds. In spite of their popularity existing algorithms are limited to a particular region of upper limb;a general algorithm involving entire upper limb which helps in clinical decision making is lacking. We attempt to propose one for the day to day clinical practice.Methods:A retrospective analysis of patients who underwent pedicled flaps for coverage of post-traumatic upper extremity (arm, elbow, forearm, wrist & hand) soft tissue defects within the period of January 2016 to October 2017 was performed. Patients were divided into groups according to the anatomical location of the defects. The flaps performed for different anatomical regions were enlisted. Demographic data and complications were recorded. An algorithm was proposed based on our experience, with a particular emphasis made to approach to clinical decision making.Results:Two hundred and twelve patients were included in the study. Mean age was 27.3 years (range: 1-80 years), 180 were male, and 32 were female. Overall flap success rate was 98%, the following complications were noted marginal flap necrosis requiring no additional procedure other than local wound care in 32 patients (15%), partial flap necrosis requiring flap advancement or extra flap in 15 patients (7%), surgical site infection in 11 patients (5%), flap dehiscence requiring re-suturing in 5 patients (2.4%), total flap necrosis 4 patients (2%).Conclusion:The proposed algorithm allows a reliable and consistent method for addressing diverse soft tissue defects in the upper limb with high success rate. 展开更多
关键词 Algorithm UPPER LIMB soft tissue defect RECONSTRUCTION Pedicled FLAPS DECISION making
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Efficacy and safety of external tissue expansion technique in the treatment of soft tissue defects:a systematic review and meta-analysis of outcomes and complication rates 被引量:1
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作者 Xirui Tong Jianyu Lu +8 位作者 Wei Zhang Siqiao Wang Runzhi Huang Xianliang Zhang Jie Huang Yushu Zhu Shichu Xiao Shizhao Ji Zhaofan Xia 《Burns & Trauma》 SCIE 2022年第1期52-70,共19页
Background:Currently,various external tissue expansion devices are becoming widely used.Considering the scarcity of relevant application standards,this systematic review was performed to explore the effectiveness and ... Background:Currently,various external tissue expansion devices are becoming widely used.Considering the scarcity of relevant application standards,this systematic review was performed to explore the effectiveness and safety of external tissue expansion techniques for the reconstruction of soft tissue defects.Method:A systematic review and meta-analysis on the efficacy and safety of external tissue expansion technique was conducted.A comprehensive search was performed in the following electronic databases:PubMed/Medline,Embase,Cochrane Library(Wiley Online Library),andWeb of Science.Studies reporting patients with soft tissue defects under the treatment of external tissue expansion technique were included.Results:A total of 66 studies with 22 different types of external tissue expansion devices met the inclusion criteria.We performed a descriptive analysis of different kinds of devices.A single-arm meta-analysis was performed to evaluate the efficacy and safety of the external tissue expansion technique for different aetiologies.The pooled mean wound healing time among patients with defects after fasciotomy was 10.548 days[95%confidence interval(CI)=5.796-15.299].The pooled median wound healing times of patients with defects after excisional surgery,trauma,chronic ulcers and abdominal defects were 11.218 days(95%CI=6.183-16.253),11.561 days(95%CI=7.062-16.060),15.956 days(95%CI=11.916-19.996)and 12.853 days(95%CI=9.444-16.227),respectively.The pooled wound healing rates of patients with defects after fasciotomy,excisional surgery,trauma,chronic ulcers and abdominal defects were 93.8%(95%CI=87.1-98.2%),97.2%(95%CI=92.2-99.7%),97.0%(95%CI=91.2-99.8%),99.5%(95%CI=97.6-100%),and 96.8%(95%CI=79.2-100%),respectively.We performed a subgroup analysis in patients with diabetic ulcers and open abdominal wounds.The pooled median wound healing time of patients with diabetic ulcers was 11.730 days(95%CI=10.334-13.125).The pooled median wound healing time of patients with open abdomen defects was 48.810 days(95%CI=35.557-62.063)and the pooled successful healing rate was 68.8%(95%CI=45.9-88.1%).A total of 1686 patients were included,265(15.7%)of whom experienced complications.The most common complication was dehiscence(n=53,3.14%).Conclusions:Our systematic review is the first to demonstrate the efficacy and safety of external tissue expansion in the management of soft tissue defects.However,we must interpret the meta-analysis results with caution considering the limitations of this review.Large-scale randomized controlled trials and long-term follow-up studies are still needed to confirm the effectiveness and evaluate the quality of healing. 展开更多
关键词 External tissue expansion Systematic review META-ANALYSIS Skin stretching soft tissue defects Wound healing
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Consecutive flap transfer for repairing massive soft tissue defects in the opisthenar with improved donor site closure 被引量:1
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作者 Wu Lehao Tong Dedi +3 位作者 Zhu Shan Zang Mengqing Tian Guanglei Chen Shanlin 《Chinese Journal of Traumatology》 CAS CSCD 2014年第5期256-260,共5页
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
关键词 soft tissue defect Free scapular flap Perforator flap
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Soft tissue defects of the hand:etiology and classification
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作者 Bruno Battiston Camillo Fulchignoni 《Plastic and Aesthetic Research》 2023年第1期381-388,共8页
Soft tissue defects of the hand may result from trauma,oncological procedures,or severe infections.Different etiologies have been discussed.In all cases,an accurate clinical examination is mandatory to understand whic... Soft tissue defects of the hand may result from trauma,oncological procedures,or severe infections.Different etiologies have been discussed.In all cases,an accurate clinical examination is mandatory to understand which structures are involved and what must be reconstructed.It can be helpful to simplify the decision-making process to classify these lesions.However,there is no consensus on which classification is best to be used among those described in the literature.This review presents the most common ones,differentiating those classically used to describe tissue loss consequential to a traumatic event from those used to classify soft tissue defects consequent to other events. 展开更多
关键词 soft tissue defect TRAUMA oncological INFECTION tissue loss
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Management of soft tissue defects of the thumb
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作者 Bram Van Hove Francisco Del Piñal 《Plastic and Aesthetic Research》 2023年第1期529-542,共14页
Hand surgery has undergone substantial changes in recent years,especially for reconstructive surgery techniques.We discuss the management of soft tissue defects of the thumb,discussing indications,and operative pearls... Hand surgery has undergone substantial changes in recent years,especially for reconstructive surgery techniques.We discuss the management of soft tissue defects of the thumb,discussing indications,and operative pearls and pitfalls.We cover non-operative treatment and local advancement flaps for small distal soft tissue defects and pedicled flaps for more significant defects.We also discuss composite vascularized free flaps such as second-toe neurocutaneous flaps and partial hallux transfer for compound defects or total amputations.This article aims to provide hand surgeons with an update on reconstructing an injured thumb. 展开更多
关键词 Hand surgery reconstructive surgery soft tissue defects THUMB TRAUMA free flap partial hallux transfer
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保留反应性软组织联合脱矿牙本质基质应用于拔牙位点保存
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作者 戴婕婷 任碧晖 +2 位作者 徐业豪 郭水根 魏洪武 《中国组织工程研究》 CAS 北大核心 2025年第17期3557-3565,共9页
背景:反应性软组织内的干细胞间充质具有促进组织再生的潜力,脱矿牙本质基质具有良好的生物相容性,可以作为位点保存术的支架材料,促进骨细胞的附着、增殖和分化。目的:影像学分析拔牙保留反应性软组织1个月后、行脱矿牙本质基质位点保... 背景:反应性软组织内的干细胞间充质具有促进组织再生的潜力,脱矿牙本质基质具有良好的生物相容性,可以作为位点保存术的支架材料,促进骨细胞的附着、增殖和分化。目的:影像学分析拔牙保留反应性软组织1个月后、行脱矿牙本质基质位点保存术后6个月牙槽骨高度和宽度的变化。方法:纳入38例患者共62个拔牙位点,拔除患牙保留反应性软组织1个月后应用脱矿牙本质基质行位点保存术,术前、术后即刻、术后6个月拍摄锥形束CT,分别测量近中骨高度、中央骨高度、远中骨高度、颊侧骨高度、舌侧骨高度、牙槽嵴宽度,根据拔牙后剩余牙槽窝骨壁数量分为一壁骨缺损、二壁骨缺损、三壁骨缺损、四壁骨缺损。比较位点保存术前、术后即刻、术后6个月的骨量变化。结果与结论:①在骨愈合期间无位点发生创口感染;②与位点保存术前比较,术后即刻骨高度、骨宽度明显增加(P<0.05);术后6个月骨高度增加(P<0.05),骨宽度无明显变化(P>0.05);与术后即刻比较,术后6个月骨宽度吸收了(1.253±2.896)mm(P<0.05),骨高度无明显变化(P>0.05);③位点保存术后即刻、术后6个月4种骨缺损类型的骨高度明显增加(P<0.05),骨宽度无显著变化(P>0.05);术后6个月较术前一壁骨缺损近中骨量增长最少(P<0.05),二壁骨缺损近中骨量增长最多(P<0.05);④结果表明:脱矿牙本质基质应用于位点保存术可有效预防和减缓拔牙术后的牙槽骨吸收,能够在一定程度上重建已发生吸收的牙槽骨轮廓;拔牙术后保留反应性组织应用于脱矿牙本质基质位点保存术中,可实现创口封闭,临床疗效好;脱矿牙本质基质应用于一壁、二壁、三壁、四壁牙槽窝位点保存效果相似,但总体而言,脱矿牙本质基质应用于骨壁完整的拔牙窝时位点保存效果更为优良。 展开更多
关键词 影像学研究 位点保存 脱矿牙本质基质 反应性软组织 骨壁缺损
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Reconstruction of soft tissue defect of the extremity with the perforator flap from inguinal region 被引量:5
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作者 HUANG Dong WANG Hai-wen +2 位作者 WANG Hong-gang WU Wei-zhi ZHAO Cheng-yi 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第23期2861-2864,共4页
Background The perforator flap has become a very useful reconstructive means of soft tissue defect of extremities. The perforator flap from the inguinal region has advantages that include the ability to cover a large ... Background The perforator flap has become a very useful reconstructive means of soft tissue defect of extremities. The perforator flap from the inguinal region has advantages that include the ability to cover a large area with little donor site morbidity and provision of suitable thickness for reconstruction. Methods From July 1, 2005 to June 30, 2007, 10 patients with various types of soft tissue defect underwent reconstruction with 10 perforator flaps from the inguinal region. Six flaps were applied to the upper extremities and four flaps to the lower extremities. The dimensions of the transferred flaps ranged from 7-30 cm in length and 4-10 cm in width. Results The postoperative course of all 10 flaps was uneventful and all flaps survived. Distal small partial necrosis was observed in one case due to arterial insufficiency of the distal part of the flap. All patients were satisfied with the functional and esthetic resurfacing outcome. Conclusion Use of perforator flap from the inguinal region could overcome the disadvantages of the traditional free groin flap, and represents a safe and useful tool for coverage of soft tissue defects. 展开更多
关键词 soft tissue defect RECONSTRUCTION perforator flap
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Three novel homozygous ITGB2 mutations among two patients with leukocyte adhesion defect type-1:Two case reports
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作者 Yiwa Suksawat Punchama Pacharn +1 位作者 Nunthana Siripipattanamongkol Boonchai Boonyawat 《World Journal of Clinical Pediatrics》 2022年第5期429-436,共8页
BACKGROUND A leukocyte adhesion defect(LAD) is a rare primary immunodeficiency disorder. LAD type 1(LAD-1) is the most common, which is caused by ITGB2 mutation resulting in dysfunction of β2 integrin, which impairs ... BACKGROUND A leukocyte adhesion defect(LAD) is a rare primary immunodeficiency disorder. LAD type 1(LAD-1) is the most common, which is caused by ITGB2 mutation resulting in dysfunction of β2 integrin, which impairs leukocyte adherence to the endothelium.CASE SUMMARY The first two cases of LAD-1 in Thailand presented with recurrent omphalitis, soft tissue infection, marked leukocytosis, and neutrophilia. One patient experienced delayed umbilical cord separation. Mutation analysis was performed by direct DNA sequencing of the ITGB2 gene. The results revealed two novel homozygous missense mutations, c.920C>T(p.Leu307Pro) in exon 8 and c.758G>A(p.Arg-253His) in exon 7, and one novel homozygous nonsense mutation, c.262C>T(p.Gln88Ter) in exon 4, in the genomic DNA of the first and second patients, respectively. Heterozygous mutations were identified in the parents of both patients, suggesting a carrier status. The patients were administered intravenous antibiotics for infections with good clinical responses. Hematopoietic stem cell transplantation could not be performed due to the unavailability of matched donors. However, a significant decline in infections was observed after antibiotic prophylaxis. Several follow-up visits were conducted for both patients. They are currently 6 years old.CONCLUSION Molecular analysis is essential for definitive diagnosis, early treatment implementation, and prevention of LAD-1 in future pregnancy. 展开更多
关键词 Leukocyte adhesion defect ITGB2 Omphalitis Bacterial soft tissue infection Molecular investigation Case report
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胸背动脉穿支皮瓣在肩胸背部创面修复中的临床应用 被引量:2
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作者 李承龙 仲海燕 +3 位作者 陈勇 王倩 邹鸣立 袁斯明 《组织工程与重建外科》 CAS 2024年第1期64-68,共5页
目的探讨胸背动脉穿支皮瓣在肩胸背部皮肤软组织缺损修复中的应用。方法自2019年1月至2022年12月,应用胸背动脉穿支皮瓣修复肩胸背部皮肤软组织缺损8例,致伤原因均为肿瘤切除术后。术前应用CTA和手持多普勒超声确认胸背动脉的存在、走... 目的探讨胸背动脉穿支皮瓣在肩胸背部皮肤软组织缺损修复中的应用。方法自2019年1月至2022年12月,应用胸背动脉穿支皮瓣修复肩胸背部皮肤软组织缺损8例,致伤原因均为肿瘤切除术后。术前应用CTA和手持多普勒超声确认胸背动脉的存在、走行、分支及穿支位置。根据创面位置、面积设计胸背动脉穿支皮瓣。皮瓣仅携带穿支发出位置的极少量肌肉,将胸背动脉降支近端从肌肉内剥离,保留胸背动脉横支和胸背神经。如血管蒂长度不足,可切断横支。皮瓣带蒂转移修复创面。供瓣区拉拢缝合。结果8例皮瓣均存活,供瓣区切口愈合好。随访6个月到2年,所有患者受区外观满意,供瓣区无明显畸形,肩关节功能无明显影响。结论胸背动脉穿支皮瓣血供可靠,血管蒂长,且基本完整地保留了背阔肌功能,是修复肩胸背部邻近创面的良好选择。 展开更多
关键词 胸背动脉穿支皮瓣 皮肤软组织缺损 肩胸背部 背阔肌
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Application of radial collateral artery perforator flap in severe posterior elbow skin defect
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作者 Qing-xin XU Guang-huai CUI +2 位作者 Zhen-zhen WAN Yu-shu LIU Wen-ming LIU 《Chinese Journal of Plastic and Reconstructive Surgery》 2019年第1期14-17,共4页
exposed wound of deep tissue behind elbow. Methods From April 2016 to December 2018, 28 patients with posterior elbow skin and soft tissue defect with exposed bone and tendon were treated in our hospital. the radial c... exposed wound of deep tissue behind elbow. Methods From April 2016 to December 2018, 28 patients with posterior elbow skin and soft tissue defect with exposed bone and tendon were treated in our hospital. the radial collateral artery perforator flap was used to repair the wound. There were 19 cases of skin defect with ulna exposure after electric shock injury, 5 cases of hot compression injury and 4 cases of bone exposure caused by skin contusion after traffic accident. Results There is no complication after the operation, all the flaps were survived. The flaps had good quality and satisfactory recovery of appearance and function. Conclusion The lateral upper arm flap designed by perforating branch of radial collateral artery is an effective method for posterior elbow skin and soft tissue defect because of its constant anatomic position and long vascular pedicle. 展开更多
关键词 RADIAL COLLATERAL ARTERY soft tissue defects PERFORATOR FLAP T ransplantation
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Flap transplantation for treatment of pelvic fracture and defective hip
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作者 Bo Feng Kecheng Niu +2 位作者 Zhi Zhang Lan Zhang Yunyan Tan 《Discussion of Clinical Cases》 2014年第1期33-39,共7页
A case of flap transplantation for treatment of pelvic fracture and defective hip in the Third Affiliated Hospital of Inner Mongolia Medical University was collected and analyzed on the basis of diagnosis,physical exa... A case of flap transplantation for treatment of pelvic fracture and defective hip in the Third Affiliated Hospital of Inner Mongolia Medical University was collected and analyzed on the basis of diagnosis,physical examination and treatment.The patient was in serious condition with large necrotic area and prone to lead to various complications.The paper aims to share experience and provide references for similar cases amongst surgeons. 展开更多
关键词 Pelvic fracture soft tissue defect Skin flap transplantation
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股前外侧皮瓣修复足踝部复合组织缺损的临床疗效分析 被引量:1
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作者 许甜甜 林平 +1 位作者 方文雅 徐伟华 《浙江创伤外科》 2024年第5期797-799,共3页
目的研究分析股前外侧皮瓣修复足踝部复合组织缺损的临床疗效。方法回顾性分析2020年1月至2023年6月本院收治的足踝部复合组织缺损患者共92例,根据皮瓣修复手术方法不同将92例患者分为两组,其中观察组51例,行股前外侧皮瓣修复治疗,对照... 目的研究分析股前外侧皮瓣修复足踝部复合组织缺损的临床疗效。方法回顾性分析2020年1月至2023年6月本院收治的足踝部复合组织缺损患者共92例,根据皮瓣修复手术方法不同将92例患者分为两组,其中观察组51例,行股前外侧皮瓣修复治疗,对照组41例,行小腿岛状穿支皮瓣修复治疗。结果观察组患者的手术治疗时间,皮瓣愈合时间均明显短于对照组患者,差异具有统计学意义(P<0.05);两组患者术后皮瓣均完全成活;术后3个月,观察组患者AOFAS评分明显高于对照组(P<0.05);术后3个月,观察组患者BMRC感觉功能恢复分级中,S3-S4级占比明显高于对照组患者(P<0.05);观察组患者术后并发症发生率(11.76%)与对照组患者术后并发症发生率(12.20%)无明显差异,比较无统计学意义(χ^(2)=0.8214,P>0.05)。结论采用股前外侧皮瓣修复足踝部复合软组织缺损,可以获得较好的临床疗效,患者术后足踝功能以及皮瓣感觉功能恢复更好,适合临床选择应用。 展开更多
关键词 股前外侧皮瓣 足踝部 复合软组织缺损 小腿岛状穿支皮瓣
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股前外侧穿支皮瓣的个性化精准设计:十年1079例临床疗效分析
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作者 唐举玉 孙念哲 +9 位作者 吴攀峰 俞芳 曾磊 卿黎明 肖勇兵 潘丁 刘睿 符劲飞 贺继强 李诚 《中国临床解剖学杂志》 CSCD 北大核心 2024年第5期510-516,共7页
目的探讨个性化精准设计的股前外侧穿支皮瓣重建各种复杂组织缺损的临床疗效。方法回顾分析我科2013年1月-2023年1月采用个性化精准设计的各种股前外侧穿支皮瓣修复的1079例患者的临床疗效。以旋股外侧动脉降支为血管蒂切取1013例(其中... 目的探讨个性化精准设计的股前外侧穿支皮瓣重建各种复杂组织缺损的临床疗效。方法回顾分析我科2013年1月-2023年1月采用个性化精准设计的各种股前外侧穿支皮瓣修复的1079例患者的临床疗效。以旋股外侧动脉降支为血管蒂切取1013例(其中小儿65例)、横支为血管蒂切取40例、斜支为血管蒂切取26例(小儿1例),以旋股内侧动脉或股动脉来源穿支为蒂切取9例。其中传统股前外侧穿支皮瓣游离移植441例、带蒂转移27例、特殊形式穿支皮瓣基本术式511例、衍生术式100例。修复下肢787例,上肢264例,躯干部17例,头颈部4例,上述多部位7例。并对各种个性化精准设计的股前外侧穿支皮瓣术后临床疗效及并发症发生率进行统计比较。结果本组1079例股前外侧穿支皮瓣中,术后顺利成活1063例,其中发生血管危象行探查术成活14例,总成功率为98.52%。比较游离股前外侧穿支皮瓣、带蒂转移、特殊形式穿支皮瓣基本术式和衍生术式各组成功率,结果显示各组间成功率无明显差异(P>0.05)。本组1079例股前外侧穿支皮瓣主要并发症发生情况:静脉危象35例(3.24%),动脉危象22例(2.04%),感染19例(1.76%),切口延迟愈合6例(0.56%),完全坏死16例(1.48%),部分坏死35例(3.24%)。统计学分析显示静脉危象方面特殊形式穿支皮瓣基本类型组发生率低于衍生术式组(P<0.001),切口感染方面带蒂转移组发生率高于特殊形式穿支皮瓣组(P=0.007),切口延迟愈合方面传统游离移植组发生率高于特殊形式穿支皮瓣组(P=0.04),皮瓣部分坏死方面带蒂转移组发生率高于特殊形式穿支皮瓣组(P=0.008)。结论股前外侧穿支皮瓣个性化精准设计,可以获得良好的临床疗效,值得临床推广应用。 展开更多
关键词 股前外侧 穿支皮瓣 个性化 精准重建 皮肤软组织缺损
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