ABSTRACT
Objective@#To explore the clinical effects of Nice knot combined with elastic compress and stretch in treating skin and soft tissue defect.@*Methods@#From August 2017 to April 2019, a total of 23 patients, 10 males and 13 females, aged 36.5±5.3 years (range 26-76 years), were retrospectively analyzed. The defect size was 60±5.3 cm2 (28-96 cm2). Under local anesthesia, the wound was debrided thoroughly, sutured and fixed by Nice knot. The wound was fixed by elastic dressing and traction. The wound was retracted every 3 days during dressing change. The wound healing grade, healing rate, healing time, and postoperative Vancouver Scar Scale (VSS) were observed and recorded.@*Results@#All operations were performed successfully in the debridement room. The operation time was 42±10.5 min (range 30-50 min), intraoperative bleeding 30±2.5 ml (range 20-60 ml), and the operation cost 180±11.5 RMB (range 160-240 RMB). Twenty patients were followed up for 4±2.5 months (range 3-6 months). The wound healing rate of 23 patients was 50%±3.5% (range 40%-56%). For the 20 patients, the wound healing rate was 65%±4.3% (range 53%-75%), 74%±4.5% (range 65%-80%), 83%±1.8% (range 76%-85%), 90%±1.6% (range 84%-95%) and 95%±3.5% (range 94%-98%) at 3, 6, 9, 12 and 15 days, respectively. The wound healing rate of 20 patients was 100% at the 42nd days of follow-up. Wound healing rate of Grade A and grade B was 95% (19/20) with scar VSS score 4(3, 6). The excellent and good rate of grade B was 80% (16/20). Two cases were sutured and fixed with Nice knot after 10 days because of the partial loss of the sutures. One case was treated with vacuum sealing drainage (VSD) on-line junction because infection was not completely controlled. Local infection was controlled and the wound was contracted by Nice junction at 1 week.@*Conclusion@#The treatment of skin and soft tis sue defect with Nice combination with elastic dressing and traction has the advantages of simple operation, low operation condition, short operation time, less bleeding, low cost, high wound healing grade and healing rate, suitable for basic level hospital application and promotion.
ABSTRACT
Objective To explore the clinical effects of Nice knot combined with elastic compress and stretch in treating skin and soft tissue defect.Methods From August 2017 to April 2019,a total of 23 patients,10 males and 13 females,aged 36.5±5.3 years (range 26-76 years),were retrospectively analyzed.The defect size was 60±5.3 cm2 (28-96 cm2).Under local anesthesia,the wound was debrided thoroughly,sutured and fixed by Nice knot.The wound was fixed by elastic dressing and traction.The wound was retracted every 3 days during dressing change.The wound healing grade,healing rate,healing time,and postoperative Vancouver Scar Scale (VSS) were observed and recorded.Results All operations were performed successfully in the debridement room.The operation time was 42±10.5 min (range 30-50 min),intraoperative bleeding 30±2.5 ml (range 20-60 ml),and the operation cost 180±11.5 RMB (range 160-240 RMB).Twenty patients were followed up for 4±2.5 months (range 3-6 months).The wound healing rate of 23 patients was 50％±3.5％ (range 40％-56％).For the 20 patients,the wound healing rate was 65％±4.3％ (range 53％-75％),74％±4.5％ (range 65％-80％),83％±1.8％ (range 76％-85％),90％±1.6％ (range 84％-95％) and 95％±3.5％ (range 94％-98％) at 3,6,9,12 and 15 days,respectively.The wound healing rate of 20 patients was 100％ at the 42nd days of follow-up.Wound healing rate of Grade A and grade B was 95％ (19/20) with scar VSS score 4(3,6).The excellent and good rate of grade B was 80％ (16/20).Two cases were sutured and fixed with Nice knot after 10 days because of the partial loss of the sutures.One case was treated with vacuum sealing drainage (VSD) on-line junction because infection was not completely controlled.Local infection was controlled and the wound was contracted by Nice junction at 1 week.Conclusion The treatment of skin and soft tissue defect with Nice combination with elastic dressing and traction has the advantages of simple operation,low operation condition,short operation time,less bleeding,low cost,high wound healing grade and healing rate,suitable for basic level hospital application and promotion.
ABSTRACT
Objective@#To observe the clinical efficacy of self-made one-fourth tubular hook plate used in the fixation of comminuted fractures of acetabular posterior wall.@*Methods@#The clinical data of 21 patients with comminuted fracture of acetabular posterior wall were retrospectively analyzed who had been treated by fixation with our self-made one-fourth tubular hook plate from June 2015 to September 2017 at Deparment I of Orhthopaedics, The Second People's Hospital of Anhui Province. They were 12 males and 9 females, aged from 20 to 59 years (mean, 38.5 years). The time from injury to surgery ranged from 3 to 6 days (average, 4.5 days). All the fractures were fixated with our self-made one-fourth tubular hook plate via the Kocher-langenbeck approach. Depending on the fracture fragments, the hook plate was cut out obliquely through the 3rd or 4th hole and the sharp end of the plate was bent into a small hook to hold the fragments. Only the hook plate was used in 6 cases and an additional construction plate in the other 15 cases. The postoperative reduction, functional recovery of the affected hip and complications were recorded.@*Results@#The follow-up averaged 13 months (from 8 to 32 months). Intermuscular venous thrombosis occurred in one patient and sciatic nerve contusion was observed intraoperatively in one patient with sciatic nerve injury. According to the improved Matta criteria, the fracture reduction was rated as excellent in 16 cases, as good in 4 and as poor in one, giving a good to excellent rate of 95.2%. The fractures united after an average of 7.5 months (from 6 to 12 months). According to the improved Merle d'Aubigné and Postel scoring system, the hip function at the final follow-up was excellent in 14 cases, good in 3, fair in 2 and poor in 2, giving a good to excellent rate of 81.0%. Follow-ups revealed traumatic arthritis in 3 cases, femoral head necrosis in 2 cases and ectopic ossification in one.@*Conclusion@#Our self-made one-fourth tubular hook plate is simple, economical and effective because it can provide easy and rigid fixation of the comminuted fractures of acetabular posterior wall, leading to fine therapeutic effects.
ABSTRACT
Objective To observe the clinical efficacy of self-made one-fourth tubular hook plate used in the fixation of comminuted fractures of acetabular posterior wall.Methods The clinical data of 21 patients with comminuted fracture of acetabular posterior wall were retrospectively analyzed who had been treated by fixation with our self-made one-fourth tubular hook plate from June 2015 to September 2017 at Deparment I of Orhthopaedics,The Second People's Hospital of Anhui Province.They were 12 males and 9 females,aged from 20 to 59 years (mean,38.5 years).The time from injury to surgery ranged from 3 to 6 days (average,4.5 days).All the fractures were fixated with our self-made one-fourth tubular hook plate via the Kocher-langenbeck approach.Depending on the fracture fragments,the hook plate was cut out obliquely through the 3rd or 4th hole and the sharp end of the plate was bent into a small hook to hold the fragments.Only the hook plate was used in 6 cases and an additional construction plate in the other 15 cases.The postoperative reduction,functional recovery of the affected hip and complications were recorded.Results The follow-up averaged 13 months (from 8 to 32 months).Intermuscular venous thrombosis occurred in one patient and sciatic nerve contusion was observed intraoperatively in one patient with sciatic nerve injury.According to the improved Matta criteria,the fracture reduction was rated as excellent in 16 cases,as good in 4 and as poor in one,giving a good to excellent rate of 95.2％.The fractures united after an average of 7.5 months (from 6 to 12 months).According to the improved Merle d'Aubigné and Postel scoring system,the hip function at the final follow-up was excellent in 14 cases,good in 3,fair in 2 and poor in 2,giving a good to excellent rate of 81.0％.Follow-ups revealed traumatic arthritis in 3 cases,femoral head necrosis in 2 cases and ectopic ossification in one.Conclusion Our self-made one-fourth tubular hook plate is simple,economical and effective because it can provide easy and rigid fixation of the comminuted fractures of acetabular posterior wall,leading to fine therapeutic effects.