ABSTRACT
【Objective】 To investigate the clinical application of self-developed magnetic anchoring device for assisting thoracoscopic pulmonary resection. 【Methods】 Eleven patients underwent thoracoscopic pulmonary assisted with resection magnetic anchoring technique at the Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, from March to May 2019. Their clinical data were retrospectively analyzed. The operation time, blood loss, blood transfusion volume, postoperative hospital stay, and postoperative complications were recorded. 【Results】 There were seven male and four female patients, with the average age of (51.6±13.9) years (range from 22 to 69 years). Three single-port and eight single-utility-port thoracoscopic surgeries were performed. Magnetic instruments provided good surgical field exposure in all operations. Among 11 surgeries, one was converted to thoracotomy and one to three-hole surgery due to enlargement and adhesion of hilar lymph nodes. The operation time was (107.8±63.1) minutes (range of 27-182 minutes). The blood loss was 50 (10-50)mL (range of 5-1 000 mL). No blood transfusion was needed during the operation. The postoperative hospital stay was (5.0±1.8) days (range of 3-9 days). No postoperative complications occurred in all the patients. 【Conclusion】 Magnetic anchor technique can effectively alleviate the "chopstick effect" in thoracoscopic surgery. Magnetic anchor technique is safe and feasible in assisting thoracoscopic pulmonary resection.
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BACKGROUND:Previously deep burn wound or skin defects are generaly repaired with skin grafting or flap of skin grafting. Obvious scar hyperplasia usualy appears after operation, which requires multiple surgeries. Meanwhile, patients have to suffer from great pain and bear high cost. OBJECTIVE: To observe the clinical effects on deep wounds by continuous traction of self-designed skin-stretching device (patent No. ZL 2012 2 0022443.7). METHODS: Thirty patients with deep burn wound, skin defect or funicular scar were enroled, including 22 males and 8 females, aged 18-49 years, and randomly divided into two groups. Skin-stretching device was adopted for skin traction treatment. Twenty cases underwent skin traction from 1 kg puling force to 5 kg, with an increase of 1 kg per 2 days, 6 hours a day for 10 days. Blood flow at the beginning, 1, 5, 10, 15, 20, 30, 60 minutes of the skin traction, and the changes of wound edge skin as wel as histological changes of the skin were observed. Of the remaining 10 cases, 2, 6, and 2 cases underwent skin traction of 2, 4, 7 kg, respectively. Blood flow and skin changes were also observed to find out the most suitable and safe force. RESULTS AND CONLUSION:Al the 30 cases achieved primary healing without necrosis of skin, infection or peripheral circulatory disorders, and the appearance and function recovered wel. The healing time was 8-24 days. The skin-stretching device was most safe under 4 kg puling force, by which, there was neither blood circulation obstacle nor tear of skin. After traction, the skin blood flow and the number of cels increased, especialy the epithelial basal cels. The colagen fibers became thicker and denser, and the elastic fibers regenerated significantly; the fibroblasts and capillary density increased. It has been proved that we can better close the wound and reduce scar formation effectively with the self-designed skin-stretching device for skin traction.
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Objective Clinical effects of dot from body skin irradiated xenogeneic skin improved composite graft.Methods Selected 80 patients with severe burn patients randomized after admission on the basis of conventional treatment,3-5 days line Crust treatment group transplanted autologous point-like skin irradiation pigskin coverage.Results Treatment of patients in group one week dressing see irradiated pigskin Tiefu full two weeks the pigskin was dry scab-like.Wound healing treatment group (29 ± 5) days (P < 0.01) was significantly shorter than the control group(39 ±4) days.Wound healing rate of treatment is significantly higher than the control group (P <0.01).Wound infection rate reduced greatly reduce labor intensity and dressing,and reduce pain.1 year after scar formation in patients with good flexibility and functionality.Conclusions Punctate since improved composite body skin irradiated xenogeneic skin transplantation can improve skin graft survival rate,promote wound healing,treatment of a large area of the burn wound repair is feasible and effective.
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Objective To investigate the efficacy and safety of compound lysostaphin disinfectant solution in the latter stage of the treatment of bum wounds infection,and to evaluate its clinical value.Methods The selected 60 cases of bum wound infection were grouped into treatment and control group at random.The treatment group recieved compound lysostaphin disinfectant solution(Shanghai Hi-tech Co.bio-engineering,Ltd.)with debridement and wet,once a day;the control group with normal saline+gentamicin wet gauze,once a day.After cleaning the wound two groups 40 cases of underwent regular skin debridement,20 cases in each group.The bacteria changes in the wound were detected,of bacteria removal the accumulated rate of wound healing time and healing rate were compared.Results 3,6,9 days after treatment the accumulated rate of bacteria removal was 45.8%,73.9%, 89.5%higherthan the control group(13.8%,27.6%,57.4%)respectively(P<0.01).Wound healing time in the treatment group was(12±5)d,shorter than the control group(16±4)d Was significantly(P<0.01). The rate of wound healing in the treatment group was significantly higher(P<0.01).No adverse reactions were found.Conclusion The treatment application of compound iysostaphin disinfectant in the later stage of bum wound is effective in control of infection,increases the survival rate of skin and shortens wound healing time,so it is safe and effective.
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Objective To analyze the treatment principles of burn patients with fractures and the clinical application of external fixation.Methods The treatment methods and efficacy in 48 patients with bum complicated fracture were summarized.Limb fractures were 53,femoral shaft 21,tibia and fibula 28,humerus 13,ulnar bone torsion 5.Closed 44,open 23.All limbs received external fixation,with single-arm multifunctional external fixator in 47,bilateral 17,Monteggia 3.Burn wound dressing was dealed with the situation in accordance with surgical debfidement or skin flap.Results The 48 cases were found no deaths,and 67 fractures healed and discharged healing time 2.5~5 months,3.1 months on average.Limb and joint function showed a good recovery.Conclusions External fixation showed fixation stability,simple operation,mild tissue injury,easy handling and anti-burn scar contracture and other advantages.Clinical results were satisfactory.