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Objective:To evaluate the clinical effect of free anterior lateral thigh flap (ALTF) with cutaneous nerve on repair and reconstruction after radical operation of tongue cancer.Methods:79 patients with tongue cancer who underwent radical resection in the stomatology department of Hunan Provincial People′s Hospital from October 2015 to October 2020 were selected and divided into observation group (38 cases) and control group (41 cases) according to the treatment method. The observation group was reconstructed with free ALTF with cutaneous nerve, and the control group was reconstructed with free ALTF without cutaneous nerve. The survival of the flap was observed and the function and morphology of the reconstructed tongue were evaluated.Results:All flaps survived and had good blood supply; the blood supply was good, the wounds healed in the first stage, and there were no cases of infection and arterial crisis. The appearance of the reconstructed tongue was plump and showed mild atrophy. The observation group was significantly better than the control group in terms of language clarity, masticatory efficiency, sensory excellence rate and University of Washington Quality of Life questionnaire (UW-QOL) score ( P<0.05). Conclusions:The ALTF with cutaneous nerve for repair and reconstruction after radical operation of tongue cancer, can significantly improve the reconstruction of tongue sensory function and the quality of life of patients.
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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.
Subject(s)
Adult , Humans , Male , Young Adult , Beijing , Burns, Electric , General Surgery , Retrospective Studies , Surgical Flaps , Thigh , Wound Healing , Wrist Injuries , General SurgeryABSTRACT
Objective@#The difference in quality of life between patients with unilateral maxillary defect repaired by free fibular flap and anterior lateral femoral perforator flap was compared with questionnaire analysis.@*Methods@#In March 2014 to June 2015, 40 cases of tumor resection caused unilateral maxillary defects were included in this study, which were treated with free fibula flap or femoral anterolateral perforator flap in Peking University Stomatological Hospital. Two groups of patients were followed up one year after surgery, and the University of Washington Quality of Life Scale score was obtained.@*Results@#The score of fibular flap group was 89.37± 15.34 and score of anterior lateral femoral perforator flap group was 88.04±15.78(t=0.17, P=0.36).@*Conclusions@#There was no significant difference between free fibular flap and anterior lateral femoral perforator flap in improving postoperative quality of life.
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Objective To evaluate the effectiveness of free anterolateral thigh flaps for the reconstruction of lower extremities vast soft tissue defect caused by Gustilo Ⅲ open fracture. Methods From June,2013 to December, 2016,pedicled vascular anterolateral thigh flaps with end-to-side vascular anastomosis were adopted to repair 10 cas-es of lower legs caused by Gustilo Ⅲ open fracture and soft tissue defects. Among those cases,6 cases combined with anterior tibial arteries injury and 4 cases with posterior tibial arteries injury. The receiving arteries were anastomosed with flaps arteries in end-to-side method and the receiving veins were anastomosed in end-to-end method. All pa-tients were regular follow-up, and follow-up contents included flap appearance, color, limb ischemia. Results All the flaps survived in10 cases. Venous crisis was happened in one case,and flap survived after the exploration. Two cases delayed healing because of wound infection.All the 10 cases were followed up for 3-24 months,with an average of 10 months.The skin flaps of 10 cases were thin and well fitted,with good appearance and soft texture. The color of the flaps were similar to that of the recipient areas.The appearance and function of the affected limbs were satisfacto-ry. Conclusion Free anterolateral thigh flap with end-to-side vascular anastomosis is an ideal method to repair the vast soft tissue defects caused by Gustilo Ⅲ open fracture.
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Objective To discuss the effectiveness of anterolateral thigh propeller flaps for treatment of inguinal skin and soft tissue defects.Methods From June,2009 to October,2014,12 patients with inguinal skin and soft tissue defects were treated with anterolateral thigh propeller flaps pedicled with perforator of descending branch of lateral circumflex femoral artery.Of them there were 8 males and 4 females,aged from 22 to 51 years.The left side was involved in 3 cases and right side 9 cases.Defects were caused by traffic accident injury in 5 cases,crash injury of heavy object in 7 cases.There were mere skin and soft tissue in 2 cases,combined with bone fractures,nerves,vessels and muscles injury in 10 cases.The area of defects ranged from 9.0 cm×5.0 cm to 22.0 cm×9.0 cm.During operation,anterolateral thigh propeller flaps ranging from 11.0 cm×7.0 cm to 24.0 cm×1 1.0 cm were used to repair the wounds.Results All flaps and skingrafts survived after operation and the wounds obtained primary healing.After 8-24 months follow-up,all flaps were characterized by soft texture,good color,and satisfactory appearance.According to the Britain's Medical Research Council at 8 months after operation,the sensation of the flaps were recovered to S2 ～ S3+,No obvious scar contracture and chromatosis were observed at donor site.Conclusion Anterolateral thigh propeller flaps pedicled with artery descending branch of lateral circumflex femoral perforator is an ideal choice for the reconstruction for inguinal skin and soft tissue defects.