Résumé
Objective:To analyze and investigate the clinical efficacy on repairing soft tissue defects of the thumb distal with dorsal neurocutaneous vascular flap.Methods:Select 100 cases of patients with soft tissue defects of the thumb distal from January 2014 to December 2016,who were randomly divided into two groups,the control group and observation group.Take the abdominal skin flap to repair soft tissue defects of the thumb distal in the control group,with the thumb distal with dorsal neurocutaneous vascular flap in the observation group.The survival condition,the indicators of feelings,the appearance of skin flap,as well as the DASH score of the hand fimction have been recorded and analyzed through follow-up patients,to observe the effects on repairing soft tissue defects in the two groups.Results:All transplanted tisssues were all survived in the observation group and control group.Compared with control group,the sense of touch,temperature sense,monofilament,two-point discrimination,scar contracture of the observation group were better(P＜0.05),the incidence of bloat was lower (P＜0.05).The DASH scores were 29.56± 2.14,38.13± 3.12 in the observation group and control group,which was significantly lower in the observation group than that of the control group(P＜0.05).Conclusion:The clinical efficacy of the dorsal neurocutaneous vascular flap is better than that of abdominal skin flap on repairing soft tissue defects of the thumb distal.For no injury for major vascular nerves,little influence on donor area,being simple to operate,being better feelings of the finger pulp,appearance,dorsal neurocutaneous vascular flap on repairing soft tissue defects of the thumb distal is an ideal choice.
Résumé
Objective To rebuild artificial external urethroplaspy and improve collecting-urine method for the patient with ileocystoplasty.Methods Abdominal tube shaped artificial external urethra were rebuilt by designing two reverse ladder shaped skin flaps,using synthetic tube shape as covering,and using distant ileum flap as lining in total cystectomy and ileocystoplasty for 17 patients with urinary bladder carcinoma during August 1993 to July 2005.Urine was collected by connecting tube shaped external urethra with condom and urine package.Results The operation of 17 artificial external urethra succeeded all.The wound of the operation healed one stage.Urine collecting was easy and less contamination.Conclusion Artificial external urethroplasty with lower abdominal wall skin-flap and ileum-flap is simple,safe,and suitable to the patients with ileocystoplasty.Urine collecting is convenient and hygiene and low-price.
Résumé
A study on abdominal skin flaps of the fresh cadavers of young men under the operation, light and scanning electron microscope, and MAS image analysis system has been made. Methods include Chinese ink, ABS or methyl methacrylate injection and histological slides, transparent specimens as well as casts preparation. The course of the vessels in the human abdominal skin flap is in the "three steps form". Trunks and main branches of the cutaneous vessels run in the deep part of the superficial fascia, their branches and terminals form anastomoses in the middle of the reticular layer of dermis, and branches from the anastomoses form microvascular network in the subpapillary layer. The vascular networks in the skin flap are concentrated in five layers: the deep fascial, superficial fascial, profund dermal, subpapillary, and papillary layers. Between the subpapillary and the profund dermal vascular networks, there is a layer devoid of vascular network and crossed by vascular arteries only. Therefore, this layer may be called as "vascular network devoid area". The differences of the area fraction (Aa) or number of vessels are not significant among various areas of the abdominal skin flap. Design in detaching the abdominal skin flaps and skin grafts is discussed.