ABSTRACT
Resumen Introducción: Las lesiones de la mano son uno de los padecimientos más frecuentemente atendidos en el Servicio de Cirugía Plástica y Reconstructiva del Hospital Central Militar, dentro de la amplia variedad de estas lesiones se encuentran las lesiones del sistema flexor. Objetivo: Estimar la incidencia, funcionalidad y tiempo de reintegración laboral en pacientes con lesiones de sistema flexor de la mano tratados en el Hospital Central Militar en el periodo del 1º de marzo del 2020 al 1º de marzo del 2022. Metodología: Estudio observacional, retrospectivo, longitudinal descriptivo en pacientes adultos con lesión de sistema flexor de la mano, en los cuales la causa de la lesión no haya condicionado un trauma complejo de la mano. Se utilizó como referencia los criterios de recuperación funcional de Strickland y Goglovac. Resultados: A pesar de que las lesiones de la zona II flexora en la literatura presentan un peor pronóstico para la recuperación de la función normal de la mano, los resultados demuestran que la mayor parte de los pacientes se encuentra en una escala funcional buena. Limitaciones del estudio: El estudio fue llevado a cabo durante el periodo comprendido por la pandemia COVID, por lo que las consultas subsecuentes con tiempos más alargados y el inicio tardío de las consultas de rehabilitación pudieron haber contribuido hacia una recuperación más deficiente de la recuperación funcional de los pacientes.
Abstract Introduction: Hand injuries are one of the conditions most frequently treated in the Plastic and Reconstructive Surgery Service of the Hospital Central Militar, within the wide variety of these injuries are injuries to the flexor system. Objective: To estimate the incidence, functionality and labor reintegration time in patients with hand flexor system injuries treated at the Hospital Central Militar in the period from March 1, 2020 to March 1, 2022. Methodology: Observational, retrospective, longitudinal, descriptive study in adult patients with injury to the flexor system of the hand, in whom the cause of the injury did not result in complex trauma to the hand. The Strickland and Goglovac functional recovery criteria were used as reference. Results: Despite the fact that flexor zone II lesions in the literature present a worse prognosis for the recovery of normal hand function, the results show that most of the patients are in a good functional scale. Limitations of the study: The study was carried out during the period covered by the COVID pandemic, so that subsequent consultations with longer times and the late start of rehabilitation consultations could have contributed to a poorer recovery of functional recovery. from the patients.
ABSTRACT
Objective:To investigate the therapeutic effect of Flow-through anterolateral thigh perforator flap (ALTPF) or medial sural artery perforator flap (MSAPF) in repair of Gustilo III C wound of foot.Methods:From July 2015 to June 2021, 8 patients with Gustilo III C wound of foot were treated in the Department of Foot and Ankle Surgery of Wuxi No.9 People’s Hospital. The patients were 7 males and 1 female, aged 25-62 years old, and (45.88±12.96) years old in average. Flow-through ALTPF or Flow-through MSAPF were used to repair the defect according to the size of the wound and the length and diameter of the defect vascular. Among the patients, 6 were repaired with free Flow-through ALTPF, and 2 with free Flow-through MSAPF. The size of flap was 9 cm×5 cm-22 cm×8 cm with (115.00±46.16) cm 2 in average, and the vascular bridging was 6-12 cm in length, with (8.75±2.50) cm in average. All patients received outpatient follow-up. The appearance of the flap, blood supply of affected limb, healing of fracture and dislocation and the recovery of limb function were recorded. Maryland score was used to evaluate functional recovery. Results:The flaps survived uneventfully in all 8 patients, and the wounds in donor site healed primarily. All patients were followed-up for 6-22 months with (12.25±5.39 ) months in average. At the last follow-up, all the flaps had satisfactory contour in soft texture and blood supply without occlusion in the bridging vessels. The fractures and dislocation were healed, and the appearance and function of the foot recovered satisfactorily. The Maryland score showed excellent in 3 patients, good in 4 patients and fair in 1 patient.Conclusion:Flow-through ALTPF or MSAPF can selectively used to reconstruct the Gustilo III C wound of foot in one stage. The functional recovery of the affected limb was satisfactory and the clinical effect was good.
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[Objective]To explore the method of rehabilitation for serious open injury below knee.[Method]A fotal of 153 cases with serious open injury below knee were treated.In which 106 cases were primary repair,47cases were second repair,treated with 7 kinds of internal fixation methods,11 kinds of flap.[Result]A fotal of 132 cases were followed up from 6 months to 5 years after operation,the average time was 17 months,the postoperative satisfaction rate was 85.7%,the flap survival rate was good 25 cases with local necrosis,4 cases with non-union,8 cases with chronic infection,3 cases with osteomyelitis.[Conclusion]The improvement of the flaps enlarge the application and reduce the complication of the flaps.The study offer a reasonable method to repair serious open injury below knee.The proficiency microsurgical scissors and reasonable application of various tissue flaps was the key to repair the injury successfully.
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Objective:To find out the common species of germ in the opening wound in limb and explore the infuence of treatment and nursing intervene in the process of wound healing on infection for the opening wound.Methods:80 cases with opening wound in limb were enrolled.Taking sample with cotton swab and bacterial culture on wound were carried out in defferent time,such as suffering injuries,initial treatment,debridment and postoperative infection.Nursing measures were recorded on wound treatment and controling the contamination or infection in the process of wound healing.Results:The detective rate about germ was 73.1%(117/160)、61.2%(98/160)、14.4%(23/160)、5.0%(8/160)in suffering injuries,initial treatment,debridment and postoperative infection respectively and no new bacterial was grown in each process.Conclusion:Severe contamination and wide species of germ were found in the opening wound in limb.Nursing intervene in the process of wound healing and wound treatment can effectively reduce the infection rate of postoperative wound.