ABSTRACT
Experience of treatment of 24 patients, suffering neck deformity and contracture, using stretched flaps with axial type of blood circulation, was summarized. In total 43 expanders were implanted. The cutaneo-fascial flaps stretching was performed in the neck and thorax. In all the flaps a nutrition artery was included. The neck-brachial flaps, including supraclavicular artery, were applied in 25 (58.1%) patients, the neck-thoracic flaps, using superficial neck artery--in 12 (27.91%), the occipital-neck flaps on a musculocutaneous perforating vessels of occipital artery--in 6 (13.95%). The methods of the expander implantation, the stretching, transposition regimes of plastic material and its fixation were elaborated. The donor sites were closed using stretched tissues, left in place after formation of flaps. Flaps were fixed, using mechanical method of the tissues connection with duplicature formation from deepidermized portion of cicatrix or with polypropylene mesh, which played a role of a dense framework. Then a strong connective tissue bolt was formed, securely fixing transposedstretched tissues. While application of a complex-component vascularized flaps a suppuration have occurred in 3 (6.97%), partial necrosis--in 2 (4.64%) observations. Inclusion of nutritive vessels permit to form large size flaps with a small risk of necrosis occurrence. The stretched perforant flaps application permits to achieve positive result in 95.3% of observations--in immediate and in 81.82%--in far remote period.
Subject(s)
Burns/surgery , Contracture/surgery , Neck , Skin Transplantation/methods , Surgical Flaps/blood supply , Adolescent , Adult , Burns/complications , Child , Child, Preschool , Contracture/etiology , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
The clinical efficacy of the preparation reamberin in correction of metabolic hypoxia in patients with severe thermal burn injury under septicotoxemia was studied. It was established high efficacy of the preparation in the correction of the antioxidant defense system, its considerable antitoxic activity. Established role of reamberin in maintaining the functioning of the humoral detoxication systems, and antimicrobial resistance in patients with severe thermal injury.
Subject(s)
Antioxidants/therapeutic use , Burns/therapy , Critical Care/methods , Hypoxia/drug therapy , Meglumine/analogs & derivatives , Sepsis/therapy , Succinates/therapeutic use , Adult , Aged , Antioxidants/administration & dosage , Antioxidants/metabolism , Burns/blood , Burns/complications , Burns/metabolism , Drug Therapy, Combination , Humans , Hypoxia/blood , Lipid Peroxides/blood , Meglumine/administration & dosage , Meglumine/therapeutic use , Middle Aged , Oxidative Stress/drug effects , Sepsis/blood , Sepsis/etiology , Sepsis/metabolism , Succinates/administration & dosage , Thiobarbituric Acid Reactive Substances/metabolism , Young AdultABSTRACT
Issues of the restoration treatment optimization of patients with locally spread extracerebral tumors (LSET) were discerned basing on analysis of 54 observations. The role of reconsructive-restoration operations, depending on the tumor localization, size and invasiveness was shown, as well as the role of radiation therapy in complex restorational treatment. Rational complex approach to conduction of rehabilitation measures constitute the factor, promoting the treatment efficacy raising and providing for satisfactory quality of life in patients with LSET.
Subject(s)
Brain Neoplasms/surgery , Head and Neck Neoplasms/surgery , Neoplasms, Second Primary/surgery , Plastic Surgery Procedures , Skull Neoplasms/surgery , Skull/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Skull Base Neoplasms/surgeryABSTRACT
The technique of dermotension, peculiarities and expediency of its use in postburn and mechanical skin deformation in 50 children ranging in age from 2 to 14 years are described. It is expedient to perform operative elimination of the postburn alopecia, severe contracture of the neck, cicatricial bandage of the chest and abdomen by means of the dermotensive flaps. This permits to reduce a number of operative steps, create a sufficient reserve of healthy tissue identical to the lost one both in texture and in colour. Dermotension has the advantages over the pediculate plasty and can be widely used in children with the burn sequelae.
Subject(s)
Burns/surgery , Tissue Expansion/methods , Adolescent , Burns/complications , Child , Child, Preschool , Contracture/etiology , Contracture/prevention & control , Humans , Wounds and Injuries/surgeryABSTRACT
The experience with performing operations in 17 patients with contracture of the neck, face, trunk with the use of composite cutaneous arterialized flaps from the lateral surface of the thoracic wall and inclusion of the latissimus dorsi has been analysed. It is established that such a plasty is attended by the lesser risk of circulatory impairement in the transferred tissues as compared with the available methods of non-free plasty.
