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面颈部毛细血管畸形的整形外科治疗 认领
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作者 陈森 李养群 +2 位作者 杨喆 王维新 马宁 《中国美容整形外科杂志》 CAS 2020年第4期217-219,226共4页
目的探讨面颈部毛细血管畸形(capillarymalformation,CM)整形外科治疗的可行性及方法。方法面颈部CM手术切除后采用游离皮片、皮瓣或扩张皮瓣等方法进行修复。预构皮瓣9例,皮片移植6例,扩张皮瓣4例,单纯皮瓣转移2例。病变面积7 cm×... 目的探讨面颈部毛细血管畸形(capillarymalformation,CM)整形外科治疗的可行性及方法。方法面颈部CM手术切除后采用游离皮片、皮瓣或扩张皮瓣等方法进行修复。预构皮瓣9例,皮片移植6例,扩张皮瓣4例,单纯皮瓣转移2例。病变面积7 cm×4 cm~27 cm×21 cm。结果本组中21例患者获随访6~60个月。修复外形良好,未见明显复发。结论对于较大面积的面颈部CM,手术大部切除后采用组织移植修复,是一种可行及效果良好的方法,可以预防病变增生进展,明显改善外貌。 展开更多
关键词 毛细血管畸形 游离植皮 皮瓣 扩张皮瓣 血管预构
Pre-expanded Muscle-sparing Latissimus Dorsi Flaps for Reconstruction of Severe Scar Contractures on the Anterior Chest 认领
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作者 Zhichao WANG Dujuan LIU +3 位作者 Shuchen GU Baoxiang TIAN Tao ZAN Bin GU 《中国整形与重建外科(英文)》 2020年第2期63-68,77,共7页
Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the l... Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery.The entire treatment period was divided into two stages,during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I,the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively;the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch;and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II,the chest scars were excised,and breast tissues were repositioned;the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery.Results From October 2010 to October 2019,21 patients(on 24 sides)underwent reconstructive procedures for extensive scar contractures on the anterior chest.All flaps survived,and their donor sites were sutured directly.During a follow-up of 3 months to 8 years,the flaps became soft and exhibited color similar to that of the adjacent tissues.The limited neck and shoulder movements improved,and postoperatively,all female patients were satisfied with the shape of their breasts.Additionally,neither apparent weakening on the adduction,internal rotation,or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed.Conclusion Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thora 展开更多
关键词 Latissimus dorsi flaps pre-expansion muscle-sparing thoracic scars
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Management of Post-Mastectomy Radio-Necrotic Ulcers &Osteoradionecrosis 认领
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作者 Alaadin Hussein Rimoun Boutros Amani Saber 《癌症治疗(英文)》 2019年第6期433-441,共9页
Background: Breast cancer is still the most common indication for chest wall irradiation, despite the advances in RTH techniques complications still occur, and the time of its occurrence vary and could take few months... Background: Breast cancer is still the most common indication for chest wall irradiation, despite the advances in RTH techniques complications still occur, and the time of its occurrence vary and could take few months to many years. ORN usually manifests with pain, exposed bone, fistulae and pathological fracture and the proper management needs proper debridement and coverage by thick musculocutaneous flaps. Objective: To evaluate different techniques of surgical management of post-irradiation persistent radio-necrotic ulcer & ORN with emphasis on the outcome of each technique. Patients and methods: A retrospective study from 2010 to 2015 reviewed 20 patients subjected to post-mastectomy radiotherapy as a treatment for breast cancer inNCICairo, and Minia oncology center Hospital, Egypt. Cases were biopsied to exclude local recurrence. The age, sex, type of ulcer, dose of radiotherapy received and the management done for these cases were recorded. Results: Only 4 patients responded to conservative treatment in the form of repeated dressings, and 16 patients needed surgical treatment;5 of them were treated with debridement and coverage with split thickness graft with high rate of complications reaching 80%, the other 11 patients were reconstructed with musculocutanoeus flaps, of these 7 patients were reconstructed with LD flaps with 57.14% success rate and minor complications only, the other 4 cases were reconstructed with TRAM flap with 50% success and major loss of the flap in one case that needed salvage by LD flap. Pre-operative comorbidity was found in 6 patients and all of them experienced complications while only 3 of the other 14 who had no comorbidity had postoperative complications. Conclusion: Pedicled flaps provide a good choice for reconstruction and provide chest wall support without the use of synthetic mesh. 展开更多
关键词 Radionecrotic Ulcer OSTEORADIONECROSIS Pedicled Myo-Cutaneous FLAPS Breast Cancer
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手指皮肤软组织缺损皮瓣修复的治疗进展 认领
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作者 刘东 周鑫 +2 位作者 伍光辉 向琳茜 罗琳 《世界最新医学信息文摘》 2019年第59期49-49,52共2页
手指皮肤软组织缺损是临床上常见的损伤,修复术式也有多种,皮瓣修复为主要修复方式。其中包括'V-Y'形推进皮瓣,游离足趾皮瓣、指动脉皮(筋膜)皮瓣、游离动脉皮瓣、静脉动脉化皮瓣等。文章从手指皮肤软组织缺损修复术式的选择,... 手指皮肤软组织缺损是临床上常见的损伤,修复术式也有多种,皮瓣修复为主要修复方式。其中包括'V-Y'形推进皮瓣,游离足趾皮瓣、指动脉皮(筋膜)皮瓣、游离动脉皮瓣、静脉动脉化皮瓣等。文章从手指皮肤软组织缺损修复术式的选择,系统的阐述各种修复手指缺损皮瓣的研究现状、适用范围及优缺点,并对手术操作及术后处理要点提出自己的看法,综述如下。 展开更多
关键词 手指 缺损 皮瓣 修复
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应用游离前臂背侧动脉穿支皮瓣移植修复手指部软组织缺损 认领 被引量:6
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作者 何小鹏 张亚斌 +5 位作者 李敏杰 姚永锋 徐文龙 蒋永彬 瞿超 庞仲辉 《临床骨科杂志》 2019年第1期60-62,共3页
目的探讨应用游离前臂背侧动脉穿支皮瓣修复手指部软组织缺损的方法和效果。方法11例手指部中小面积皮肤缺损患者,应用游离前臂背侧动脉穿支皮瓣进行修复,以前臂后侧皮神经重建感觉,皮肤缺损面积2.5cm×2.0cm~8.0cm×3.0cm,皮... 目的探讨应用游离前臂背侧动脉穿支皮瓣修复手指部软组织缺损的方法和效果。方法11例手指部中小面积皮肤缺损患者,应用游离前臂背侧动脉穿支皮瓣进行修复,以前臂后侧皮神经重建感觉,皮肤缺损面积2.5cm×2.0cm~8.0cm×3.0cm,皮瓣切取面积3.0cm×2.3cm~9.0cm×3.5cm。血管采用端端或端侧吻合法,随访观察皮瓣外形及感觉恢复情况。结果11例患者均获得随访,随访时间6~12个月。皮瓣全部成活,外观良好、质地佳、感觉恢复满意,供区仅残留线状瘢痕。按中华医学会手外科学会上肢部分功能评定试用标准评定疗效:优7例,良4例。结论游离前臂背侧动脉穿支皮瓣具有血供可靠、切取方便、质地优良、供区损伤小等特点,是修复手指部中小面积缺损较好的方法。 展开更多
关键词 皮瓣 前臂背侧动脉 穿支 手指软组织缺损
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双侧V-Y推进皮瓣联合人工指甲修复指端缺损疗效分析 认领
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作者 何县委 吴荣博 《创伤外科杂志》 2019年第4期281-283,共3页
目的采用双侧三角形V-Y推进皮瓣联合人工指甲修复指端皮肤软组织缺损伴指骨外露,分析其治疗效果。方法2012年6月—2012年12月笔者科室共收治指端皮肤软组织缺损伴指骨外露患者42例42指,指端皮肤缺损面积均≤1.5cm2,均采用双侧三角形V-Y... 目的采用双侧三角形V-Y推进皮瓣联合人工指甲修复指端皮肤软组织缺损伴指骨外露,分析其治疗效果。方法2012年6月—2012年12月笔者科室共收治指端皮肤软组织缺损伴指骨外露患者42例42指,指端皮肤缺损面积均≤1.5cm2,均采用双侧三角形V-Y推进皮瓣联合人工指甲修复。术后随访6个月,检测患者指腹外观、关节活动范围、出汗情况、两点分辨觉。结果42例指端缺损皮瓣完全存活40例,感染1例,坏死1例。术后6个月随访,42指中39指指腹形态自然饱满,外形满意,3指因皮瓣远端瘢痕愈合,外形欠佳;42指中40指指腹皮温无明显下降,1指因皮瓣坏死而明显减退,1指因感染而皮温明显增加;42例患指中39例(93%)功能恢复到正常范围;所有患指两点分辨觉均在8mm以内。结论双侧三角形V-Y推进皮瓣联合人工指甲修复指端皮肤软组织缺损伴指骨外露,手术操作简单,外观满意,术后功能恢复良好,是修复手指末端组织缺损较为理想的方法。 展开更多
关键词 软组织缺损 指端 皮瓣 人工指甲
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骨间背侧血管为蒂穿支岛状筋膜脂肪瓣充填治疗先天性上尺桡关节融合 认领
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作者 陈山林 刘路 +5 位作者 童德迪 栗鹏程 武竞衡 杨勇 荣艳波 蒋协远 《中华整形外科杂志》 CAS CSCD 北大核心 2019年第9期881-886,共6页
目的介绍骨间背侧血管为蒂穿支岛状筋膜脂肪瓣充填治疗先天性上尺桡关节融合的临床效果.方法 2013年12月至2018年1月,北京积水潭医院共收治8例先天性上尺桡关节融合患者,均采用去除融合处骨质、桡骨近端截骨、肱二头肌止点重建联合肘肌... 目的介绍骨间背侧血管为蒂穿支岛状筋膜脂肪瓣充填治疗先天性上尺桡关节融合的临床效果.方法 2013年12月至2018年1月,北京积水潭医院共收治8例先天性上尺桡关节融合患者,均采用去除融合处骨质、桡骨近端截骨、肱二头肌止点重建联合肘肌+骨间背侧血管为穿支蒂的前臂背侧筋膜脂肪瓣充填进行治疗,患者男6例,女2例,平均年龄7岁(5~12岁).双侧5例(1例右侧手术,4例左侧手术),单侧3例(右侧2例,左侧1例).Cleary分型Ⅱ型1例,Ⅲ型7例.所有患儿手术侧前臂都处于不同程度的旋前位(0°~80°,平均43°).患者术后3 d开始交替佩戴旋后及旋前支具,4周后开始主、被动旋转功能锻炼及肘关节屈伸活动锻炼.于夜间隔日交替佩戴旋前、旋后支具至术后半年.结果 8例患儿均获得平均27个月随访(6~48个月).7例重建的上尺桡关节间隙清晰,未见再融合迹象;1例12岁患儿术后重建关节处部分再融合,1年后取出桡骨固定钢板,同时重新磨断骨融合处,并植入异体肌腱团.术后随访半年,重建关节间隙清晰.6例患儿术后伸指功能正常,2例术后出现伸指无力,其中1例2个月后恢复,另1例3个月后基本恢复.6例患儿术后伸肘功能正常,2例术后伸肘受限(15°和20°).术后最后一次随访时,患者前臂活动度旋前平均32.5°(10°~65°),旋后平均31.9°(10°~70°).结论骨间背侧血管为穿支蒂的前臂背侧筋膜脂肪瓣充填治疗先天性上尺桡关节融合,手术方法相对简单,治疗结果满意,但存在桡神经深支损伤等风险. 展开更多
关键词 皮瓣 截骨术 尺桡骨融合
甘氨酸对大鼠皮瓣缺血再灌注损伤后保护的实验研究 认领 被引量:1
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作者 张晓燕 芮永军 +1 位作者 盛涛 潘筱云 《中华手外科杂志》 CSCD 北大核心 2019年第1期55-58,共4页
目的研究不同浓度甘氨酸对皮瓣缺血再灌注损伤的影响及机制。方法取50只3个月龄左右的健康SD雄性大鼠,随机分为5组,手术暴露腹部岛状皮瓣,分别于阻断血流前30 min向皮瓣蒂部动脉注射1.5 ml 0.9%生理盐水(A组)、50 mmol/L甘氨酸(B组)、10... 目的研究不同浓度甘氨酸对皮瓣缺血再灌注损伤的影响及机制。方法取50只3个月龄左右的健康SD雄性大鼠,随机分为5组,手术暴露腹部岛状皮瓣,分别于阻断血流前30 min向皮瓣蒂部动脉注射1.5 ml 0.9%生理盐水(A组)、50 mmol/L甘氨酸(B组)、100 mmol/L甘氨酸(C组)、400 mmol/L甘氨酸(D组)、1000 mmol/L甘氨酸(E组)。缺血6 h后再灌注,灌注之前5 min腹腔注射1.5 ml 0.9%生理盐水或不同浓度甘氨酸,于再灌注后1、6、12 h从蒂部静脉采集血样,测定血浆肿瘤坏死因子α(TNF-α)含量;12 h时取大鼠皮瓣组织测定丙二醛(malondialdehyde,MDA)及超氧化物歧化酶(superoxide dismutase,SOD)水平。结果不同浓度甘氨酸组的TNF-α含量和MDA水平明显低于生理盐水组,而SOD水平明显高于生理盐水组(P<0.05)。甘氨酸浓度较高的D,E组与浓度较低的B,C组比较,差异也有统计学意义(P<0.05)。结论甘氨酸通过降低血浆中TNF-α含量和MDA水平,并提高SOD水平来减轻大鼠皮瓣缺血再灌注损伤。 展开更多
关键词 甘氨酸 再灌注损伤 皮瓣 肿瘤坏死因子Α
某型飞机双向液压锁故障研究 认领
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作者 张文洲 李见 《航空维修与工程》 2018年第8期95-96,共2页
针对某型飞机地面试车时襟翼下掉不能正常收放故障现象进行了排查和分析,在分解双向液压锁后检查发现故障原因是YYS7-105螺母断裂,进一步分析确定了螺母断裂的原因,制定了相应的改进措施,避免了该型飞机类似故障的再次出现。
关键词 襟翼 双向液压锁 断裂
Reconstruction of post-traumatic upper extremity soft tissue defects with pedicled flaps: An algorithmic approach to clinical decision making 认领
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作者 Ravikiran Naalla Shashank Chauhan +1 位作者 Aniket Dave Maneesh Singhal 《中华创伤杂志:英文版》 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
后缘弧形襟翼的气动特性研究 认领
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作者 崔钊 张毅 +1 位作者 张宏林 傅见平 《飞行力学》 CSCD 北大核心 2018年第1期7-11,共5页
针对格尼襟翼低头力矩较大的问题,提出了后缘弧形襟翼概念作为格尼襟翼的改进构型,该构型通过襟翼背风面形成的局部高压区域来提供附加抬头力矩。基于CFD数值计算模型分析了弧形襟翼的气动力特性和襟翼附近的流场特征。计算结果表明:... 针对格尼襟翼低头力矩较大的问题,提出了后缘弧形襟翼概念作为格尼襟翼的改进构型,该构型通过襟翼背风面形成的局部高压区域来提供附加抬头力矩。基于CFD数值计算模型分析了弧形襟翼的气动力特性和襟翼附近的流场特征。计算结果表明:弧形襟翼的低头力矩明显低于相同高度的格尼襟翼;相比格尼襟翼,升力系数和阻力系数虽略有减小,但升阻比增大;尖部向流场中延伸能够进一步降低襟翼的低头力矩。相比格尼襟翼,弧形襟翼更有利于在飞行器设计中实际应用。 展开更多
关键词 翼型 襟翼 气动特性 数值模拟
前臂骨间背侧皮瓣修复手部伸指肌腱外露 认领 被引量:2
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作者 李金华 王衍彪 刘立峰 《中国矫形外科杂志》 CAS CSCD 北大核心 2018年第9期806-809,共4页
[目的]探讨坏死型伸指肌腱经皮瓣覆盖后的疗效及临床价值。[方法]2010年10月~2016年10月,采用前臂骨间背侧动脉逆行岛状皮瓣修复90例伸指肌腱外露坏死患者。因感染或就诊不及时皮瓣修复二期进行,术中全部保留或大部分保留坏死的伸指肌... [目的]探讨坏死型伸指肌腱经皮瓣覆盖后的疗效及临床价值。[方法]2010年10月~2016年10月,采用前臂骨间背侧动脉逆行岛状皮瓣修复90例伸指肌腱外露坏死患者。因感染或就诊不及时皮瓣修复二期进行,术中全部保留或大部分保留坏死的伸指肌腱,并予以皮瓣覆盖。[结果]90例患者接受手术,术后皮瓣均顺利成活,术中未发生新的重要血管、神经损伤。创面Ⅰ期愈合37例,但是由于肌腱或深部组织感染严重,部分皮瓣周围持续渗出,伤口持续渗出者给予清洁换药,保持引流通畅(或部分患者给予清创),均获得愈合,术后二期愈合46例。创面愈合时间14~56 d,平均(20.16±4.73)d。术后83例获随访,随访时间3~36个月,平均(22.64±5.16)个月。术后1、2个月时各有2例患者发生伤口破溃,渗液溢出,经换药(或简单清创)伤口再次愈合,末次随访时,除6例患者出现关节僵硬、活动度差,其余患者均感满意。皮瓣外形较好,无明显臃肿,根据手指关节总活动度(total active motion,TAM)评定标准:优良率92.8%。患指伸指肌力:优良率97%。未伤指组的掌指关节、近指关节和远指关节活动主评分均高于伤指组,但两组间掌指关节、近指关节和远指关节活动主评分的差异,均无统计学意义(P〉0.05)。[结论]伸指肌腱即便坏死仍有保留价值,应用骨间背皮瓣修复后仍可以获得良好功能。 展开更多
关键词 骨间背侧动脉 皮瓣 伸指肌腱 坏死
额部旋转皮瓣在外伤性额部皮肤软组织缺损修复中的应用 认领 被引量:1
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作者 徐俊华 张明 +1 位作者 张国华 张奕 《海南医学》 CAS 2018年第19期2750-2752,共3页
目的探讨额部旋转皮瓣修复外伤性额部皮肤软组织缺损的临床效果。方法武汉科技大学附属普仁医院骨科2012年12月至2017年5月对8例外伤性额部皮肤软组织缺损采用额部旋转皮瓣修复,治疗后观察皮瓣愈合、皮瓣感觉功能及术后相关并发症发生... 目的探讨额部旋转皮瓣修复外伤性额部皮肤软组织缺损的临床效果。方法武汉科技大学附属普仁医院骨科2012年12月至2017年5月对8例外伤性额部皮肤软组织缺损采用额部旋转皮瓣修复,治疗后观察皮瓣愈合、皮瓣感觉功能及术后相关并发症发生情况。结果经过12个月随访,8例外伤性额部皮肤软组织缺损均修复良好,皮瓣愈合良好,皮瓣感觉功能恢复可,无术后相关并发症发生。结论额部旋转皮瓣修复外伤性额部皮肤软组织缺损的临床应用效果满意。 展开更多
关键词 皮瓣 额部 缺损 软组织 修复
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When free flaps are not the first choice: is the distally based peroneus brevis still an option for foot and ankle reconstruction in the era of microsurgery? 认领
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作者 Raymund E.Horch Ingo LudoIph +4 位作者 Marweh Schmitz Anja M.Boos UIrich Kneser Justus P.Beier Andreas Arkudas1 《整形与美容研究(英文版)》 2018年第7期26-34,共9页
Aim: Soft tissue defects with or without exposed bones in the lower extremity, ankle and the foot-with or without bone defects or exposed hardware-often require coverage with vascularized flaps. Free flaps, which add ... Aim: Soft tissue defects with or without exposed bones in the lower extremity, ankle and the foot-with or without bone defects or exposed hardware-often require coverage with vascularized flaps. Free flaps, which add healthy tissue especially to the lower extremity instead of further injuring a limb, are the first choice in high volume microsurgical centres. Nevertheless, in some instances pedicled flaps may have indications when free flaps are not suitable. Methods: The distally based peroneus brevis flap is harvested from the lateral compartment of the leg based on the distal perforating arterial supply and covered with split skin. Results: We performed a total of 69 peroneus flaps between 2003 and 2017. Minor flap necroses at the distal tip were noted in 8% of the peroneus brevis reconstructions. Total flap loss occurred in 1 peroneus flap. Defect etiology and patient age were not associated with surgical outcome. Conclusion: While nowadays the first choice of lower extremity reconstruction is an appropriate free flap solution,the peroneus brevis muscle flap can also be seen as a valuable tool to reconstruct small to medium sized defects at the ankle, distal tibia, and the heel with an acceptable donor site morbidity. Despite the easily available variety of free flaps to achieve this purpose, still proper indications remain where a local flap can be a viable option in the hand of experienced plastic surgeons. However, caution is advisable in patients with peripheral arterial occlusive disease or venous insufficiency. 展开更多
关键词 Free FLAPS peroneus brevis muscle FLAP lower EXTREMITY RECONSTRUCTION
A novel highly specialized functional flap: omohyoid inferior belly muscle 认领
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作者 Gerado Mu■oz-Jimenez Jose E.TeIich-Tarriba +2 位作者 Damian Palafox-Vidal AIexander Cardenas-Mejia Manuel Gea González 《整形与美容研究(英文版)》 2018年第4期23-27,共5页
Aim: There is no previous description on the anatomy of the inferior belly of the omohyoid muscle. This muscle has specific morphological characteristic that make it appealing when solving specialized reconstructive p... Aim: There is no previous description on the anatomy of the inferior belly of the omohyoid muscle. This muscle has specific morphological characteristic that make it appealing when solving specialized reconstructive problems. Our objective is to describe the microsurgical anatomy of the inferior belly from the omohyoid muscle. Methods: Supraclavicular bilateral dissection in 5 anatomic models (fresh human cadavers). Measurements were taken with a millimetric caliper. Statistical analysis was performed with measures of central tendency. Results: Eight muscles were dissected in 5 anatomic models. Average dimensions were: 93 mm long, 12 mm wide, and 7.5 mm thickness. The vascular pedicles showed great anatomical variability. In 2 flaps (1 model) irrigation came exclusively from transverse cervical vessels, in the remaining models the pedicles came directly from the subclavian vessels;2 flaps had an accessory minor pedicle from the transverse cervical vessels. The diameter of all vascular pedicles was less than 0.8 mm, with an average length of 22.3 mm. The nerve pedicle came from ansa cervicalis in all flaps, with an average length of 27.8 mm. Conclusion: Based on the findings we conclude that omohyoid muscle could be a reconstructive option when small functional flaps are required, such as facial reanimation surgery, sphincters, ptosis and vocal cord reconstruction, and blink restoration surgery although more anatomical studies are required to determine the microsurgical feasibility, excursion and strength of the muscle, and axonal load in this new myofunctional flap. 展开更多
关键词 NECK muscles free tissue FLAPS CADAVER models ANATOMIC supermicrosurgery infrahyoid muscles omohyoid MUSCLE
全飞秒激光小切口角膜基质透镜取出术(SMILE)角膜帽与飞秒激光辅助的准分子激光角膜原位磨镶术(FS-LASIK)角膜瓣的对比 认领 被引量:2
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作者 胡雅斌 周跃华 +3 位作者 张晶 张丽 郑燕 刘倩 《眼科新进展》 CAS 北大核心 2018年第9期869-872,共4页
目的对比全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)制作的角膜帽和飞秒激光辅助的准分子激光角膜原位磨镶术(femtosecond laser in situ keratomileusis,FS-LASIK)制作的角膜瓣的特点。方法 ... 目的对比全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)制作的角膜帽和飞秒激光辅助的准分子激光角膜原位磨镶术(femtosecond laser in situ keratomileusis,FS-LASIK)制作的角膜瓣的特点。方法 100例200眼近视患者根据手术方式分为SMILE组、FS-LASIK组,每组各50例100眼。SMILE组角膜帽及FS-LASIK组角膜瓣厚度均设定为110μm,RTVue-OCT测量术眼角膜0°和90°两条子午线所在截面上特定7个点的角膜帽和角膜瓣厚度值,并对角膜帽和角膜瓣上14个测量点的厚度进行对比。结果术后1周,SMILE组中央区角膜帽厚度为(109.4±2.8)μm,低于FS-LASIK组中央区角膜瓣厚度[(111.2±3.6)μm],差异有统计学意义(t=-3.062,P〈0.01)。SMILE组全角膜帽厚度值为(109.3±2.1)μm,亦低于FS-LASIK组全角膜瓣厚度[(111.1±1.8)μm],差异有统计学意义(t=-5.130,P〈0.01)。两组在不同离心度的位置,角膜帽和角膜瓣厚度的变异均不大。两组角膜0°和90°经线所在截面的平均角膜帽和角膜瓣厚度差异均无统计学意义(均为P〉0.05)。SMILE组中与预计值差值≤5μm的有1170个测量点,而FS-LASIK组中有1226个测量点。结论SMILE制作的角膜帽与FS-LASIK制作的角膜瓣同样具有良好的重现性,且形态均一、规整。 展开更多
关键词 小切口基质内透镜取出术 Visumax飞秒激光LASIK 近视 角膜瓣
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耳后带蒂肌骨膜瓣及自体骨粉在开放式乳突根治术腔填塞术中的应用研究 认领 被引量:9
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作者 董吕华 毛华杰 赵波 《中国耳鼻咽喉头颈外科》 CSCD 2017年第8期427-428,430共3页
开放式乳突根治术是治疗中耳胆脂瘤及骨疡型中耳炎的主要手术方式,但手术后留下的宽大乳突术腔及外耳道后壁缺损给患者带来诸多不便,部分患者难以获得干耳,并影响听力重建的效果。外耳道后上壁重建术是消除开放式乳突术腔的常用手术方式... 开放式乳突根治术是治疗中耳胆脂瘤及骨疡型中耳炎的主要手术方式,但手术后留下的宽大乳突术腔及外耳道后壁缺损给患者带来诸多不便,部分患者难以获得干耳,并影响听力重建的效果。外耳道后上壁重建术是消除开放式乳突术腔的常用手术方式,我们先前曾利用自体耳屏软骨重建外耳道后上壁及上鼓室外侧壁,术后获得接近正常的外耳道生理功能,但随着随访时间的延长, 展开更多
关键词 外科皮瓣(Surgical Flaps) 中耳炎(Otitis Media Suppurative) 乳突术腔填塞(mastoid cavity obliteration) 自体皮质骨(autogenous bone powder)
三体船纵向减摇附体设计及减摇效果分析 认领 被引量:1
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作者 原新 张欣 《武汉理工大学学报:交通科学与工程版》 2017年第4期554-558,共5页
三体船由于其快速性好、效率高、稳定性优良而备受青睐.为了减小由于侧体存在带来的纵摇和垂荡对船体运动性能的影响,在船底部四个位置安装三种水平翼距船底基线高度以及四种翼面迎流攻角共11种工况进行模型仿真;在主体船尾安装三种弦... 三体船由于其快速性好、效率高、稳定性优良而备受青睐.为了减小由于侧体存在带来的纵摇和垂荡对船体运动性能的影响,在船底部四个位置安装三种水平翼距船底基线高度以及四种翼面迎流攻角共11种工况进行模型仿真;在主体船尾安装三种弦长、三种下反角共六种工况的压浪板.经研究,通过比较安装两种减摇附体前后三体船的水动力性能,得到T型翼较佳的安装位置和迎流攻角以及压浪板的最佳弦长和下反角. 展开更多
关键词 三体船 T型翼 压浪板 纵向减摇 模型仿真
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Current applications of propeller flaps in reconstruction of trunk wounds 认领
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作者 Shawn Moshreif Gordon K.Lee 《整形与美容研究(英文版)》 2017年第11期204-208,共5页
Aim: Propeller flaps provide excellent reconstructive options for defects of many etiologies. Trunk wounds are a commonly encountered issue for the plastic surgeon and multiple techniques to address them should be pre... Aim: Propeller flaps provide excellent reconstructive options for defects of many etiologies. Trunk wounds are a commonly encountered issue for the plastic surgeon and multiple techniques to address them should be prepared for implementation. Propeller flaps are a subject rarely brought up as an option to address these wounds. The authors sought to elucidate this topic in the current plastic surgery literature available. Methods: A PubMed search was conducted based upon the defined inclusion and exclusion criteria and publications reviewed in detail. Search terms included 'trunk wound propeller flap', 'trunk propeller flap', and 'freestyle trunk wound flap'. Duplicate studies were excluded. Data was extracted from each study pertaining to trunk wounds and reconstructions with propeller flaps. Results: The electronic search yielded 49 results with 21 studies ultimately meeting inclusion criteria. A total of 365 flaps were described collectively amongst the included studies. Among them, 190 propeller flaps addressing trunk defects were performed across all studies reviewed to address a total of 165 defects of the trunk: 14 abdomen, 101 back, 50 chest defects and adjacent respective flaps were utilized for surgical reconstruction. Overall, cancer excision wounds were by far the most prevalent with 105 cases (59.0%). Defect sizes of those specified in the articles ranged from 2 cm × 5 cm to 30 cm × 24 cm. Of the 190 propeller flaps identified, 63 total complications were identified. The most common complication was 48 total cases of transient venous congestion (25.3%). The second most common complication was partial flap necrosis (6.3%). No total flap loss was noted. There were 2 cases of seroma (1.1%) and 1 case of wound breakdown (0.5%). Conclusion: Propeller flaps are a viable reconstructive option for trunk wounds and should be in the armamentarium of plastic and reconstructive surgeons. Few studies are available in the literature regarding propeller flap reconstruction in trunk wounds. More aggregate data is n 展开更多
关键词 PROPELLER FLAPS TRUNK WOUNDS MICROVASCULAR DISSECTION
Gustilo-Anderson ⅢB、ⅢC型胫骨开放骨折的一期修复重建策略 认领 被引量:4
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作者 陈雪松 《创伤外科杂志》 2017年第1期5-8,共4页
笔者回顾国内外文献,结合自身经验探讨Gustilo-AndersonⅢB、ⅢC型胫骨开放骨折的治疗流程和方案选择。遵循高级创伤生命支持(advanced trauma life support,ATLS)原则,尽早预防性使用广谱抗生素,高质量的清创,在损害控制外科理念指... 笔者回顾国内外文献,结合自身经验探讨Gustilo-AndersonⅢB、ⅢC型胫骨开放骨折的治疗流程和方案选择。遵循高级创伤生命支持(advanced trauma life support,ATLS)原则,尽早预防性使用广谱抗生素,高质量的清创,在损害控制外科理念指导下应用当代显微外科及标准的骨折固定技术,一期重建软组织的同时尽可能确定性固定骨折能显著减少严重胫骨开放骨折的术后并发症。 展开更多
关键词 胫骨开放骨折 皮瓣 修复 一期
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