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The case of long-term complicated infectious mass on the inner thigh root after transobturator urethral sling is rare. This paper reported a case, who underwent a surgery of the "trans-obturator mid-urethral slings" for stress urinary incontinence 9 years ago. A mass on the root of the right thigh was found 3 months ago, accompanied with low fever. About 1cm tape was exposed on the front wall of the right side of the vagina. The patient underwent resection of the mass on the root of the right thigh and partial removal of the tape under spinal anesthesia. After one year’ follow-up, there was no significant change in urinary control ability compared with that before the operation.
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Objective:To explore the effect of neurolysis and tendon transplantation in functional reconstruction of the upper limb with severe thermal crush injury.Methods:A retrospective case series study was conducted to analyze the clinical data of 12 patients with thermal crush injuries of the upper limb admitted to Changhai Hospital of Naval Medical University from January 2014 to December 2018. There were 9 males and 3 females, aged 22-54 years (mean, 38 years). The percentage of total body surface area (TBSA) burn ranged from 3% to 8% [(4.9±1.4)%], and wound depth was III degree. According to the damage condition of nerve/tendon and whether there was any dysfunction of the affected limb after wound healing, 12 patients received 2 to 4 times of neurolysis and tendon transplant-related surgeries, with an average surgery of 2.7 times. Among them, a total of 18 times of neurolysis were performed, including 7 times of radial neurolysis, 6 times of median nerve neurolysis and 5 times of ulnar neurolysis, and 14 times of tendon transplantation were done, including 6 times of anastomosis of superficial flexor tendon and long thumb extensor tendon, 5 times of tendon repair transplantation and 3 times of anastomosis of lateral wrist extensor tendon and long thumb extensor tendon. The time interval of each operation was 3-6 months [(4.5±1.0) months]. The Changhai pain ruler, disability of arm-shoulder-hand table (DASH) and joint activity assessment table were assessed before the first operation, 3 months and 6 months after the last operation.Results:All the patients were followed up for 6-12 months (mean, 9.2 months). The score of Changhai pain ruler in the affected limb improved from 3 (2, 3)points before surgery to 1 (0.5, 1)points 3 months after surgery and 1 (0, 1)points 6 months after surgery ( P<0.01). The score of DASH improved from (69.9±2.7) points before surgery to (35.1±1.7) points 3 months after surgery and (33.8±2.0) points 6 months after surgery ( P<0.01). The range of motion score was improved from (1.3±0.5) points before surgery to (2.4±0.5) points 3 months after surgery and (2.8±0.4) points 6 months after surgery ( P<0.01). Conclusion:Neurolysis and tendon transplantation in the treatment of severe thermal crush injuries of the upper limb can alleviate pain in the affected limbs, improve upper limb dysfunction, increase mobility of the palm and upper limb joints, and enhance the quality of life of the patients.
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Objective@#To explore the effect of debridement combined with vacuum sealing drainage (VSD) on the treatment of severe infection in abdominal wall due to allogeneic umbilical cord embedded in abdominal wall for immunotherapy.@*Methods@#From January 2015 to December 2016, 12 patients with severe infection in abdominal wall due to allogeneic umbilical cord embedded in abdominal wall for immunotherapy were admitted to our department. They were conducted with systemic anti-infective treatment, local debridement, and VSD. The wounds were continuously washed for 3 to 5 days after the VSD device installed, with negative pressure value from -16.0 to -12.0 kPa. The VSD device was removed 5 to 7 days later. Continue wound dressing by aseptic ribbon gauze was stuffed in the cavity, and the incision was sutured after the granulation tissue grew well in the cavity.@*Results@#In all patients, allogeneic umbilical cords were completely removed and abdominal infection was cured. The wounds healed well, the sensory function of abdominal was normal, and the activity was not restricted. All the patients were followed up for 3 to 6 months with no reinfection or incisional hernia.@*Conclusions@#Embeding the whole allogeneic umbilical cord in abdominal wall for immunotherapy can lead to severe infection in abdominal wall. Abdominal infection can be cured by debridement combined with VSD with good clinical results.