ABSTRACT
Objective To explore the clinical significance of protection "Choke vessel area" in the application of perforator flap to repair large defect of trunk after tumor resection.Methods A total of 62 patients (38 males and 24 females,aged from 19 to 79 years) from the Department of Plastic Surgery,Second Affiliated Hospital of Suzhou University underwent reconstructive surgery for large area defects of the trunk from March 2012 to January 2016.The perforator flap was designed according to the perforator location detected by Doppler before surgery.The flaps were harvested on the pedicle of perforators and dissected on the deep layer of deep fascia (including part of the myolemma).The areas of flap ranged from 5.0 cm × 10.0 cm to 19.0 cm × 22.0 cm.The donor site was sutured directly or local flap was transferred to repair.Results Flaps survived well in 59 of the 62 cases.The tip of flap was necrotic and healed after dressing change in 1 diabetic patient.The distal part of flap was necrotic on cuticular layer and healed after dressing change in another patient with scrotal defect.One patient had flap necrosis 10 days after operation and was repaired twice.The results were satisfied after following-up from 3 months to 2 years for 17 cases and from 6 months to 2 years for 25 cases.Fibrosarcoma protuberant and squamous cell carcinoma recurred in 1 case each,but the function and appearance were satisfactory after primary repair.Conclusions The procedure of preserving Choke vessel area can improve the blood supply of perforator flap and obtain larger survival area and survival quality.It is worthy of clinical application.
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Objective To discuss the effect of self- care education at the early time of postoperation and the use of nursing packages during the later period on non- throat patients. Methods 40 patients having un-dergone total laryngectomy were divided into the control group and the experimental group according to the surgery date with 20 cases in each group. The control group received conventional nursing, while the experi-mental group was given the system intervention by specialized nurses. The intervention content included self-care education at the early time of postoperation and the use of nursing packages during the later period. The questionnaire survey was carried out 15 days and 3 months after operation.The coping style,self-care ability and survival quality were compared between the two groups. Results The comparison of coping style showed re-markable difference in the two groups. The comparison of self- care ability and level of health knowledge showed significant difference 15 days after operation except two other items,but the four items demonstrated significant difference 3 months after operation. Difference also existed in the total scorn of survival quality. Conclusions Early system serf- care education after operation and the use of nursing package during the later period can impel the patients to cope positively, enhance self-care ability and survival quality.
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Objective To observe the survival quality of cerebral infarction patients in sub-acute seizure phase, who were in different TCM syndrome types. Methods The patients with cerebral infarction in acute seizure phase targeted to the inclusion criteria were divided into the heat group and non-heat group by TCM syndrome differentiation. After 4 weeks of routine treatment with western medicine, the survival quality of patients was evaluated with Health Questionnaire Short Form-36 (SF-36). Results In all dimensions of SF-36, the scores of social function, mental health, role-emotional dimensions in the heat group were obviously lower than those in the non-heat group (P
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Fouty-four patients with craniopharyngioma were admitted trom Junuary 1982 to February 1993 for post-operative radiotherapy. The 5-year survival was 78.9%. Among these 44 patients, 15 were adults and 29 were children. The children gave a higher 5-year survival rate but poorer quality of life as compared with the adults though without statistical significance in the survivals. Among the children, a dose of 56.1～60.0Gy gave better survival as compared with the 45～56Gy group without significance though causing obviously sequelae, eg: amenorrhea and hampered sex development (P