【摘要】 目的 探討應用足底內側動脈穿支蒂皮瓣修復足跟皮膚缺損的臨床應用。 方法 1998年9月-2009年3月，應用此皮瓣修復足跟皮膚軟組織缺損42例。術前對創面作充分準備，術中以術前彩色多普勒超聲探測的足底內側血管及穿支走向為軸心，根據需要設計皮瓣，沿皮瓣兩側向中間顯露，在踇展肌與趾短屈肌之間解剖出足底內側血管主干，顯露動脈穿支及伴行神經。將血管向近端分離獲得足夠長度后，掀起皮瓣，切取完成并將皮瓣行明道轉移修復創面。 結果 除2例術后4 d出現皮瓣遠端部分壞死，經換藥后愈合，其余40例皮瓣均全部成活。 結論 足底內側動脈穿支蒂皮瓣是修復足跟軟組織缺損的一種理想皮瓣。【Abstract】 Objective To study the clinical application of perforator artery flap of medial plantar in repairing skin defect of the heelstick. Methods From September 1998 to March 2009, skin defects of the heelstick of 42 patients were repaired with the perforator artery flap of medial plantar. Adequate preparations were given on the wound before operation. Based on the results of color Doppler ultrasound of the medial plantar vascellum before or during the operation, the flap was designed according to the size of the defect and transferred to repair the defect. Results All the flaps survived completely except two flaps were partial lynecrotic in the distal, which healed after change of dressing. Conclusion Perforating artery flap of medial plantar is an ideal way to repair skin defect of the heelstick.
【摘要】 目的 探討垂直上蒂法乳房縮小整形術在治療巨乳癥中的改良應用。 方法 2007年1月-2009年10月對18例乳房肥大患者行垂直上蒂法乳房縮小整形術，設計乳暈下做垂直切口，乳房下皺襞上1～2 cm做弧形切口;乳暈上新乳頭區域去皮制皮下蒂，切開形成左右兩側皮瓣，乳頭乳暈垂直向上折疊縫合于新乳頭位置，逐步分次去除多余皮膚及乳腺組織，不懸吊固定切除后的乳腺組織，向中央收緊乳房，獲得輪廓飽滿、曲線圓滑的新乳房。 結果 手術效果良好，乳房外形飽滿，輪廓曲線圓滑，隨訪半年后乳頭乳暈感覺恢復良好，切口瘢痕小，患者滿意。 結論 此改良法治療中重度巨乳癥術后乳房形態效果滿意，設計與手術操作簡便，值得推廣。【Abstract】 Objective To explore the improved application of vertical superior pedicle breast reduction mammaplasty in macromastia treatment. Methods Between January 2007 to October 2009, arc incision above submammary fold 1 - 2 centimeters and vertical incision through inferior mammary areola were designed.New mamillary region skin superior mammary areola was deepithelialized and formed subcutaneously pedicle.Mammary areola and nipple subcutaneously pedicle were vertically upward plicating sutured to form new nipple area, the redundant skin and mammary gland were gradually excised, and obtained a new saponaceous curved mammary. Results Totally 18 cases (36 mammaries) were performed by this method.After 6 months’ follow-up, the results showed that new mammaries had good shape, saponaceous outline and little scar in incision, sensation on mammary nipple and areola recovered.All patients were satisfied with the postoperative results. Conclusion Improved vertical superior pedicle breast reduction is an ideal breast reduction method for moderate and severe macromastia, and the technique is convenient in design and operation.
Objective To introduce a modified method to correct type I and type II cup ear and to evaluate the effectiveness. Methods Between May 2006 and November 2011, 23 patients with type I or type II cup ear (27 ears, type I in 6 ears and type II in 21 ears according to Tanzer’s criteria) were treated. There were 14 males and 9 females with an average age of 10 years (range, 7-16 years). The unilateral ear was involved in 19 cases and bilateral ears in 4 cases. The main clinical manifestations included the flat helix and scapha and ptosis of upper 1/3 auricle. The arc incision was adopted in the auriculocephalic angle, elevation of the dis-clothing-like flap in the front and rear of the auricular cartilage, relocation of the craniofacial initiation site of the scapha and the cavity of auricular concha, correction of deformational auricular cartilage and reconstruction of smooth helix, antihelix, superior and inferior antihelix crus. Results All the incisions healed by first intention without any hematoma, postoperative infection, or flap necrosis. All patients were followed up 9 months-6 years (median, 36 months). No auricle ptosis, deformity contour, or atrophy was observed. The structure of the helix, scapha, and antihelix were clear, natural, and excellent. The scars at the local site were limited and unconspicuous. Conclusion Modified method can almost correct all the anatomic defects of cup ear. It is an ideal method to treat type I and type II cup ear.
