ABSTRACT
Objective@#The clinical application of free perforator flaps in aesthetic repairing of the wounds of electric injuries in forearms and palms.@*Methods@#20 cases of skin tissue defects of electric injuries in forearms and palms were collected in this group, including 18 male patients and 2 female patients ranged from 20 to 50 years. The size of the skin defects are from 7 cm×5 cm to 18 cm×8 cm. 20 cases of forearms and palms with electric injuries, all of which were repaired by the transplantation of free musculocutaneous perforator monoflaps with anastomosis of interregional blood vessels. 10 cases of wounds in forearms were treated with lateral femoral circumflex artery perforator flaps with sensate nerves. The other 10 cases of wounds in palms were treated with medial plantar artery perforator flap with sensate nerves, with a flap area of 8 cm× 6cm to 20 cm×9 cm. In the donor area, 10 cases were closed with aesthetic suture and 10 cases were repaired with skin grafts.@*Results@#All flaps survived in 20 cases. Artery crisis was found in 1 case on the second day after surgery, and this flap with anastomosis of blood vessels also survived after surgical exploration without delay. The shapes and functions of palms and forearms were observed basically restored from a aesthetic point of view from a follow-up of 3 months to 36 months. Most touch, pain and warm senses were restored in cases with sensate nerves. And a two-point discrimination was 9—11 mm. A satisfactory functional recovery was achieved. The donor sites were found well-healed without any obvious scars or functional disorders.@*Conclusions@#Because of the advantages of hidden donor sites, reliable blood supply, closed texture and good abrasion-resistance, the multiple perforator sublobe flaps with sensate nerves could be adopted, and after thinning could be used as the free flaps to repair the wounds. These have predicted that this method is one of the desirable methods of aesthetic repairing and functional reconstruction of subunits skin tissue defects in palms and forearms.
ABSTRACT
Objective To investigate the clinical application value of ductoscopic flushing in the treatment of early lactation acute mastitis.Methods 52 patients with early acute mammitis were divided into observation group (27 cases)and control group(25 cases)according to the principle of completely random.In the observation group, the patients were checked under the intervention of mammary duct firstly,and then the disease regions of the breast were flushed using ductoscope.In the control group,the patients were treated with artificial breast -milk.The two groups were all treated with the same antibiotics.The curative effect of the two groups was observed,and the statistical analysis was performed.Results In the observation group,the mass extinction time,pain relief time,pyretolysis time, hemogram recovery time,contralateral continued breast -feeding proportion,the proportion of abscess formation,the proportion of back -milk,the proportion of ipsilateral quadrant recurrence were (3.5 ±1.2)h,(5.0 ±0.9)h, (1.0 ±0.1)d,(1.0 ±0.3)d,92.6%,7.4%,7.4%,0.0% respectively,those in the control group were (24.0 ± 3.2)h,(2.0 ±2.1)h,(2.0 ±0.2)d,(3.0 ±0.3)d,88.0%,12.0%,12.0%,8.0% respectively.The differences between the two groups were statistically significant(t =1.72,0.36,0.43,0.72,χ2 =1.83,2.02,1.56,0.34,all P <0.05).Conclusion Ductoscopic flushing has good effect in the treatment of early lactation acute mastitis,and it is worthy of clinical promotion.
ABSTRACT
Objective To investigate the value of mammotome minimally invasive puncture drainage in the treatment of breast abscess.Methods 53 patients with the breast abscess were divided into minimally invasive group (27 cases)and open group(26 cases)according to the principle of completely random.The patients in the minimally invasive group were treated with mammotome minimally invasive puncture drainage under the ultrasound guidance.The patients in the open group underwent conventional breast abscess incision and drainage.All the patients were treated with systemic anti -infection and symptomatic treatment.Then,we collated and analyzed the statistical data from the operation time,postoperative pain time,pain degree,number of dressing,healing time,postoperative breast feeding and breast appearance aspects.Results There was no significant difference in operation time between the two groups.In the minimally invasive group,the time of pain,the degree of pain,the time of dressing change,the healing time,the proportion of nursing and the appearance of the breast were (2.6 ±0.8)d,(2.1 ±0.2)min,(7.3 ±0.6)times, (1 8.0 ±0.1 )d,81 .5%,(3.5 ±0.2)points respectively.Those in the open group were (5.2 ±0.2)d,(3.3 ± 0.3)min,(28.0 ±0.2)times,(30.0 ±0.8)d,26.9%,(2.1 ±0.2)points respectively.The differences between the two groups were statistically significant(t =-3.38,-5.1 2,-5.61 ,-5.39,χ2 =32.25,t =-6.1 2,all P <0.05). Conclusion Minimally invasive treatment is a good method in the treatment of breast abscess,and deserved to be promoted clinically.
ABSTRACT
Objective To investigate the clinical application and effecacy of ulnar-sided thumb ladder progressive flap in repairing grade Ⅰ and Ⅱ thumb oblique wound.Methods Between October 2009 and October 2013,ulnar-sided thumb ladder progressive flap with double blood supply was transferred to cover the grade Ⅰ and Ⅱ thumb oblique wound in 24 patients (12 males and 12 females).Mean age was 30 years (range,10-40 years).Mechanism of injury was machine twist injury in 8 patients,machine cutting injury in 6,sharp weapon injury in 6 and injury by a heavy object in 4.Twelve patients had grade Ⅰ defect and twelve patients grade Ⅱ defect.Flap ranged in size from 1.0 cm ×3.0 cm to 1.5 cm × 3.5 cm.Flap advancement distance was 1.5-2.5 cm.Donor area was sutured directly.Wound healing and color,swelling and temperature of the flap were observed after operation.Finger function was assessed with the upper limb function evaluation standard set up by hand surgery branch of Chinese Medical Association.Results Postoperatively,the flap survived and the fingertip had protective sensation.The wound healed by first intention.Two patients developed distal interphalangeal joint stiffness,and restored to normal after rehabilitation.All patients were followed up for 1-36 months (mean,20 months).Finger color,temperature,texture and pulp were restored.Finger function recovered satisfactorily,with excellent results in 22 patients and good results in 2 patients.Conclusion The procedure is easy and reliable,has affirmative effect and achieves maximal preservation of finger length and function.
ABSTRACT
Objective To investigate the clinical effect of inherent artery dorsal perforator flaps of thumb radial palmar for coverage of ipsilateral thumb degree Ⅰ and Ⅱ oblique defect of the fingertip.Methods The study included 6 males and 6 females,aged 10-40 years (mean 30 years),with thumb fingertip Ⅰ and Ⅱ degree defect treated between October 2009 and October 2013.Injury resulted from machinery cutting injury in 4 patients,machinery twist injury in 3,cutting by sharp weapons in 3,and crush injury in 2.There were 6 patients with Ⅰ degree defect and 6 patients with Ⅱ degree defect.Defects were all oblique involving more in the radial side rather than in the ulnar side and reconstructed with thumb radial palmar artery perforator flaps.Flap ranged in size from 1 cm × 2 cm to 1.5 cm × 2.5 cm.Donor site was covered with skin grafts.Observation indexes were wound healing condition,flap color,flap swelling degree,and flap temperature.Finger function was measured with upper extremity scoring system formulated by Hand Surgery Branch of Chinese Medical Association.Results All flaps survived and achieved good protective sensation.Wound healed primarily.Color,temperature and texture of the flap returned to almost normal.Moderate swelling of the flaps was detected and subsided around one week.All patients were followed up for 1-36 months (mean 20 months).At the final follow-up,two-point discrimination was 9-11 mm (mean 10 mm).Two patients developed distal interphalangeal joint stiffness and recovered after rehabilitation exercise.Finger function was rated as excellent in 10 cases and good in 2.Conclusion Inherent artery dorsal perforator flap of thumb radial palmar has affirmative effect and allows maximum preservation of finger length and function when applied to repair ipsilateral thumb degree Ⅰ and Ⅱ oblique defect of the fingertip.
ABSTRACT
The article analyzed the problems of the improper orientation of the teaching objective, the imperfect coursesystem, the excessive shifting of the teaching approaches and the reverse effect of the test system. It also put forward thesolutions such as working out the syllabus fit for all the colleges and universities, giving free rein to the extracurricularactivities, and strengthening teachers' training and improving the test system ect.[