Objective: To summarize the application and effect of thin flap repairing method after reascularization in femoral anterolateral free flap. Methods: From May 2013 to October 2015, 20 cases of patients received femoral...Objective: To summarize the application and effect of thin flap repairing method after reascularization in femoral anterolateral free flap. Methods: From May 2013 to October 2015, 20 cases of patients received femoral anterolateral free flap transplantation, with the flap transported to the recipient site. After reascularization, the phase I of thin flap repairing was performed in each 'vein type'area. Among those, there existed 8 cases of direct suture in the donor site, and 12 cases of skin transplantation by intermediate split thickness skin graft. Results: All the postoperative flaps survived, with 2 cases of vascular crisis and 2 cases of poor venous return at the edge of flap. No complications such as flap infection and necrosis occurred. Wounds and incisions in donor and recipient sites were healed in phase I. 20 cases of patients had been followed up for 5-24 months, and the average follow-up time was 15 months. The skin texture of flap was similar to the surrounding skin, with good abrasion resistance, no ulceration and no phase II flap repairing;the sensation of flap recovered to S3-S4 level;the two-point discrimination was 3.5-6.0 mm, with the average value of 5.0 mm. The function of patients' fingers recovered well without any complications such as contracture and deformity etc. In the last follow-up, Testative Evaluation Standard of Upper Limb Function, which was established by Chinese Medical Society for Surgery of Hand, was used to assess efficacy, and the evaluation results were as follows: excellent in 9 cases, good in 5 cases, fair in 6 cases;in accordance with the evaluation criteria listed in Michigan Hand Outcome Questionnaire (used to assess patients' satisfaction with the appearance of flaps after operation, and the results were as follows: very satisfactory in 9 cases, satisfactory in 9 cases, and moderate in 2 cases. Conclusions: After reascularization in femoral anterolateral free flap grafting, phase I of thin repairing has small effects on flap vascularization, with a satisfactory appearance of the flap.展开更多
Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data ...Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018.The clinical and pathological data were extracted from electronic hospital medical records.We obtained follow-up information through clinic visits.Results The injury sites for all 8 patients were the wrists,specifically 5 right and 3 left wrists,all of which were on the flexor side.Five patients had ulnar artery embolism necrosis and patency,with injury to the radial artery.Two patients had ulnar and radial arterial embolization and necrosis.The last patient had ulnar arterial embolization and necrosis with a normal radial artery.After debridement,the wound area ranged from 12 cm×9 cm to 25 cm×16 cm.The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns.Free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)were used to repair the wounds.The prognosis for all patients was good after six months to one year of follow-up.Conclusion Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice.The use of free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns.展开更多
文摘Objective: To summarize the application and effect of thin flap repairing method after reascularization in femoral anterolateral free flap. Methods: From May 2013 to October 2015, 20 cases of patients received femoral anterolateral free flap transplantation, with the flap transported to the recipient site. After reascularization, the phase I of thin flap repairing was performed in each 'vein type'area. Among those, there existed 8 cases of direct suture in the donor site, and 12 cases of skin transplantation by intermediate split thickness skin graft. Results: All the postoperative flaps survived, with 2 cases of vascular crisis and 2 cases of poor venous return at the edge of flap. No complications such as flap infection and necrosis occurred. Wounds and incisions in donor and recipient sites were healed in phase I. 20 cases of patients had been followed up for 5-24 months, and the average follow-up time was 15 months. The skin texture of flap was similar to the surrounding skin, with good abrasion resistance, no ulceration and no phase II flap repairing;the sensation of flap recovered to S3-S4 level;the two-point discrimination was 3.5-6.0 mm, with the average value of 5.0 mm. The function of patients' fingers recovered well without any complications such as contracture and deformity etc. In the last follow-up, Testative Evaluation Standard of Upper Limb Function, which was established by Chinese Medical Society for Surgery of Hand, was used to assess efficacy, and the evaluation results were as follows: excellent in 9 cases, good in 5 cases, fair in 6 cases;in accordance with the evaluation criteria listed in Michigan Hand Outcome Questionnaire (used to assess patients' satisfaction with the appearance of flaps after operation, and the results were as follows: very satisfactory in 9 cases, satisfactory in 9 cases, and moderate in 2 cases. Conclusions: After reascularization in femoral anterolateral free flap grafting, phase I of thin repairing has small effects on flap vascularization, with a satisfactory appearance of the flap.
基金Beijing Jishuitan Hospital Nova Program Funding[XKXX201617]。
文摘Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018.The clinical and pathological data were extracted from electronic hospital medical records.We obtained follow-up information through clinic visits.Results The injury sites for all 8 patients were the wrists,specifically 5 right and 3 left wrists,all of which were on the flexor side.Five patients had ulnar artery embolism necrosis and patency,with injury to the radial artery.Two patients had ulnar and radial arterial embolization and necrosis.The last patient had ulnar arterial embolization and necrosis with a normal radial artery.After debridement,the wound area ranged from 12 cm×9 cm to 25 cm×16 cm.The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns.Free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)were used to repair the wounds.The prognosis for all patients was good after six months to one year of follow-up.Conclusion Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice.The use of free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns.
