Ten cases of soft tissue defect at palm orwrist were repaired by reversed fasciocutaneousflap from the forearm. All were. survived excepttwo cases having necrosis of the distal portion ofthe graft. The blood supply of the skin of the fore-arm was comming from the perforation fasciocuta-neous and musculocutaneous giving rise from theulna , radial and interosseous arteries. Therefore ,when the flap was designed,it was best to have thefascial pedicle over the arterial trunks in order toinclude more perforating arteries in the flap . It was indicated that venous supply might also played an important role in flap nutrition.
This paper reported the method tendon reconstruction on dogs. Using the pedicled fascio-tendon graft, the flexor tendon system was constructed, and comparative study was made between the vascularized fascio-tendon graft and the free fascio-tendon graft by means of oxygen tension measurement, stereology, histology and ultra-mieroseoppy. The results showed: 1. vascularized graft changed the course of healing of the conventional graft into a simplified tendon stump healing course which shortened the healing time, ahd reduced the formation of peritendinous.2. the fascia tissue could be transformed into the synovial-like tissue6 weeks postopertively under the stimulation of gliding pressure of the tendon.It was conclude that this was a new and better method in reconstructing the severely damaged flexor tendon system.
Since October 1984, we have designed a method of conversed transplant of radial styloid bone flap with fascial pedicle in the treatment of 22 patients with non-united waist fractures of carpal scaphoid. The results from follow-up of 2-7 years were satisfactory.This article introduced the design of the bone flap, the operative procedure and the advantages of the bone flap.
The noses of eight patients being dead for 2hours were dissected to investigate the layers andstructure of the nose, and the stability of theimplanted silicone noae prosthesis was tested.According to the structure and microstructure ofthe nose studied by us, we suggested a newconcept of nasal muscle and dorsal deepfasciacomplex. We confirmed the prcathesis should beimplanted in the space between the nasal boneand the complex. The reason for complicationhappened in this approach was that...
OBJECTIVE: To evaluate the clinical efficacy of fasciocutaneous flap in the repair of the III degree burn wound in the facio-cervical region. METHODS: From January 1997 to October 2001, 11 cases of III degree burn wounds in the facio-cervical region were repaired with the cervical-thoracic fasciocutaneous flap ranging from 18 cm x 8 cm to 13 cm x 5 cm. Donor sites were covered with "Z" plasty or skin grafting. RESULTS: Except for partial necrosis of distal end of the flap in 1 case, the flaps in the other 10 cases all survived and presented satisfactory appearance and function during the following up. CONCLUSION: The fasciocutaneous flap in the cervical-thoracic region may provide a large area of flap, and can be easily transferred. It’s an ideal flap for the repair of skin defect in the facio-cervical region, especially for the repair of the wounds with infection or exposure of vessel, nerve and tendon.
ObjectiveTo evaluate the clinical experiences and treatment effectiveness of chronic venous insufficiency with venous ulcer in lower limb. MethodsSeventy-eight patients (88 limbs) suffering lower limb chronic venous insufficiency with venous ulcer from May 2004 to April 2011 in this hospital were analyzed retrospectively. All the patients had undergone high ligation for great saphenous vein plus endovenous laser treatment plus subfascial endoscopic perforator vein surgery (SEPS). ResultsPostoperative complications included 3 cases of subfascial haematoma; 2 cases of pneumohypoderma; 3 cases of numbness in anterior tibial and ankle areas. All the ulcers healed between 4 to 6 weeks. Follow up period was between 6 months to 5 years. There was only one recurrence due to residual varicose from ankle area. The mean operation time was 20 min (15－30 min) in SEPS, the average blood loss was 2 ml (1－5 ml), and the mean duration of postoperative hospitalization was 5 d (2－8 d). ConclusionsSEPS is a first treatment choice for CVI with venous ulcer. It has less invasiveness, lower chances for bleeding, shorter operation time, quicker recovery, and fewer complications.
ObjectiveTo explore the effectiveness of retrograde island neurocutaneous flap pedicled with lateral antebrachial cutaneous nerve in the treatment of soft tissue defect of the hand.
MethodsBetween October 2011 and December 2013, 17 cases of skin and soft tissue defects of the hands were treated. There were 8 males and 9 females, aged 23-62 years (mean, 44 years). Of them, defect was caused by trauma in 13 cases, by postoperative wound after degloving injury in 2 cases, and by resection of contracture of the first web in 2 cases; 13 cases of traumas had a disease duration of 2-6 hours (mean, 3.5 hours). The defect sites located at the back of the hand in 5 cases, at the radial side of the palm in 4 cases, at the first web in 2 cases, at the palmar side of the thumb in 4 cases, and at the radial dorsal side of the thumb in 2 cases. The bone, tendons, and other deep tissue were exposed in 15 cases. The defect size varied from 3 cm×3 cm to 12 cm×8 cm. The size of the flaps ranged from 3.6 cm×3.6 cm to 13.2 cm×8.8 cm. The lateral cutaneous nerve of the forearm was anastomosed with the cutaneous nerve of the reci pient sites in 9 cases. The donor sites were repaired by free skin graft or were sutured directly.
ResultsThe other flaps survived, and obtained healing by first intention except 2 flaps which had partial necrosis with healing by second intention at 1 month after dressing change. The skin graft at donor site survived, and incisions healed by first intention. All patients were followed up 5-30 months (mean, 12 months). The flaps had good color and texture. Flap sensory recovery of S2-S3+ was obtained; in 9 cases undergoing cutaneous nerve flap anastomosis, the sensation of the flaps recovered to S3-S3+ and was better than that of 8 cases that the nerves were disconnected (S2-S3). The patients achieved satisfactory recovery of hand function. Only 2 cases had extended limitation of the proximal interphalangeal joint. At last follow-up, according to the Chinese Medical Society of Hand Surgery function evaluation standards, the results were excellent in 15 cases and good in 2 cases.
ConclusionRetrograde island neurocutaneous flap pedicled with lateral antebrachial cutaneous nerve is an effective way to repair skin defects of the hand, with the advantages of rel iable blood supply and simple surgical procedure.
OBJECTIVE: To investigate the therapeutic effect of subfascial endoscopic perforator vein surgery (SEPS) in treatment of varicose of the lower limb. METHODS: From 1999. 11 to 2000. 12, 108 patients with varicose of the lower limb underwent venous surgery and 34 of them were treated by SEPS. There were 16 males and 18 females aged 20-79(averaged 51.4 years). Thirty limbs (26 cases) had open ulcers and the diameter of ulcer was 1.5-12.0 cm. Eleven limbs (8 cases) had severe pigmentation and the skin changes had been presented for 1 month to 15 years. According to the severity of illness, flush saphenofemoral ligation, great saphenous vein stripping, percutaneous continuous venous circum suture, external femoral vein valve repair and SEPS were performed separately or simultaneously. RESULTS: Active ulcers healed in 19 limbs after 1 month, in 7 limbs after 3 months, and in the other 4 ulcers after skin transplantation. There was no ulcer recurrence during follow-up (ranged 9-22 months). CONCLUSION: SEPS can accelerate the healing of venous ulcers, and it is one of important methods in the treatment of chronic venous insufficiency.
OBJECTIVE The correction of ectropion of lower lid and severe infra-orbital soft tissue depression is very difficult. Former methods included simple skin graft, tubed graft, transfer of local skin flap and so on. These methods had some disadvantages, such as not enough tissue to fill the depression, too much damage done to the donor area and operation in stages required. METHODS After investigation on the anatomy of temporal region, designed the following method. Combined transfer of the galea aponeurotica and temporal fascia was used to repair severe infra-orbital soft tissue depression and ectropion of lower lid in 6 cases. RESULTS It was discovered that the combined transfer of the galea aponeurotica and temporal fascia was rich in blood circulation because they received blood supply from parietal branch of superficial temporal artery and could be transferred to a distance as far as 15-18 cm. The skin graft used to cover the fascia usually resulted in good survival. This technique was used in 6 cases with good success. CONCLUSION This method had some merits such as the tissue flap had good blood supply, little damage done to the donor area, good correction of the severe depression, good appearance following correction, operation done under local anesthesia and completed in one-stage operation.
Objective To investigate the application of arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Methods From February 1999 to December 2004, 18 cases of skin and soft tissue defect in axillary region, elbow and forearm were treated with arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Arm medial fascio-cutaneous flap was directly transferred in 3 cases, adversely transferred in 15 cases. The flap area was 4.5 cm×8.5 cm. Results Vein circulation crisis was observed in 3 cases. Of the3 cases, 1 was necrosis and the other 2 by decompressing small vein were saved.The rest 15 cases survived.The period of follow-up was 3 to 30 months. Flap was satisfactory in appearance and function. Conclusion Arm medial fascio-cutaneous flap pedicled withcutaneous nerve and nutrient vessels can be directly or adversely transferred to repair adjacent soft tissue defect.
