For the reconstruction of lacrimal passage in obligue facial cleft, three methods were performed in 4 cases. According to the difference in local pathology canaliculorhinestomy, transfer of vein or oral mucosa, or modified dacryocystorhinostomy was performed. The patients were followed for 6 to 12 months with satisfacting results.
Objective To investigate the surgical procedures and cl inical outcomes of the neurovascular free flap based on dorsal branch of digital artery of ring finger graft for repair of finger pulp defect. Methods From February 2006 to May 2009, 11 cases (11 fingers) of finger pulp defect with tendon and bone exposure were treated, including 8 males and 3 females with an average age of 29 years (range, 23-40 years). The defect locations were thumb in 2 cases, index finger in 5 cases, and middle finger in 4 cases. The defect size ranged from 1.0 cm × 1.0 cm to 2.5 cm × 2.0 cm. The time frominjury to operation was 1-9 hours. The flap size ranged from 1.5 cm × 1.5 cm to 3.0 cm × 2.5 cm. Five flaps carried the dorsal branch of digital nerve, 6 flaps carried nervi digitales dorsales. The flaps were cut from proximal radial dorsal ring finger in 4 cases and from promximal ulnar dorsal ring finger in 7 cases. Defect of donor site was repaired with full-thickness skin grafting. Results All flaps and grafted skins survived; wound and incision of donor site achieved heal ing by first intention Eleven patients were followed up 6 to 24 months with an average of 12 months. The other finger flaps had good texture and shape except for 1 flap with sl ightly bloated. The activities of finger distal interphalangeal joint were normal, the two-point discrimination of finger pulp was 7-12 mm. The extension and flexion activities of donor fingers were normal, the ringl ike thread scar left at the donor site. Conclusion It is an ideal method to use the neurovascular free flap based on dorsal branch of digital artery of ring finger graft for repair of finger pulp defect, which has the advantages of simple operation, good appearance, and functional recovery.
Taking Wistar rats and pigs as models, the basic fibroblast growth factor (bFGF) was studied on wound healing. Five rats and five pigs were used in the experiment. Each rat had 2 roundshapedwound (1.8cm in diameter) and each pig had 4 wounds of the same size as that ofthe rat. One wound of each rat and 2 wound of each pig were dressed with bFGF saline (60U/cm2). While the other wounds of the rats and pigs were dressed with normal saline as control. The wounds treated with bFGF were completely covered with granulation tissue on the 7th day after injury, and in 14 days the wounds were almost completely covered by epithelium. The bFGF would enhance the growth of theepithelial cells, reepithelization of the wound and the tensile strength of thetissue. It was concluded that the bFGF could promote skin regeneration, whichmight be the direct action of bFGF on the bFGF receptors in the basic cells of skin.
Objective To sum up the experimental and clinical history as wellas latest development of repair of growth plate injury Methods Recent articles about repair of growth plate injury were extensively reviewed and major reparative methods were introduced, especially including tissue engineering research on growth plate.Results Repair of growth plate injury was a great difficulty inexperimental study and clinical treatment of pediatric orthopedics. Transplantation of free growth plate and cartilage were unfavorably used because of lack ofblood supplement. Although circulation problem was solved by transplantation ofvascularized growth plate, autografts of epiphyseal cartilage were involved in limitation of donor, and allografts of epiphyseal cartilage induced immunological reaction. Noncartilaginous tissue and material could only prevent formation of bony bridge in small defect of growth plate and lacked ability of regenerative repair. Transplantationof tissue engineered cartilage and chondrocytes might be a choice for repair ofgrowth plate injury Conclusion Owing to lack of safe and effective methods ofrepairing growth plate injury, research on chondrocyte and tissue engineered cartilage should be further done.
Objective To discuss and evalue the effects and the advantages of pectoral is major myocutaneous flap in repair of defect caused by resection of tonsillar cancer. Methods The data were retrospectively summarized from 10 patients with recurrent tonsillar cancer after radical radiotherapy from January 1998 to December 2005, including 7 cases of squamouscell carcinoma, 2 cases of undifferentiated carcinoma, and 1 case of adenoid cystic carcinoma. There were 8 males and 2 females, aged 43-68 years with an average of 58 years. All cases were classified as stages III and IV before radiotherapy according to staging standard of oropharyngeal cancer (International Union Against Cancer, 1997). The time of relapse was 6-32 months after radiotherapy. Recurrent tonsil cancer invased tongue base, soft palate, posterior wall of pharyngeal, parapharyngeal space, and palate. Tumor size was from 4 cm × 2 cm to 8 cm × 5 cm. Seven cases were accompanied by lymph node metastasis. After carcinoma were completely resected and defects were reconstructed by pectoral is major myocutaneous flap of 7 cm × 5 cm- 12 cm × 9 cm. The donor sites were sutured directly. Results After operation, pectoral is major myocutaneous flap completely survived in 9 cases. Partial necrosis of pectoral is major myocutaneous flap was found in 1 case; after treatment, the necrotic flap remained small pharyngeal defect. Incision at donor site healed by first intention in 10 cases. All patients showed satisfactory functions of respiratory, voice, and swallowing with no compl ication. Ten patients were followed up 2 years to 5 years and 8 months. The 3-year survival rate was 66.7% (6/9), and the 5-year survival rate was 20.0% (1/5). Conclusion Pectoral is major muscle flap has a high survival rate, which is safe, rel iable, easy-to-operate, and can repair larger defect. Pectoral is major myocutaneous flap is an ideal material in repair of defect caused by resection of recurrent tonsillar carcinoma after radiotherapy.
In order to repair palpebral defects resulted from various causes, frozen tarsus of eyelid from newborn was used. From Jan. 1993 to Feb. 1995, the frozen preserved tarsus of eyelid from new-born was used to repair the palpebral defect in 10 cases. These defects were resulted following operation in traumatic defect in 5 cases, tramatic defect in 3 cases and congenital defect in 2 cases. After 3 month to 3 years follow-up, no refection reaction was found and no complication was occurred. The external appearance following repair was good. The overall successful rate was 100%. It was suggested that the frozen preserved tarsus from new-born was a safe and reliable material in the repair of palpebral defects.
【Abstract】 Objective To introduce the cl inical appl ication of heterogeneity (cattle) acellular dermal matrix(ADM)in the repair of mucosa defect otolaryngology. Methods From October 2006 to March 2007, 12 cases of mucosa defect was repaired with heterogeneity ADM after the surgery. There were 10 males and 2 females, aged 18-76 years. Defect was caused by deflection of nasal septum in 1 case, melanoma of front and midst basal is (capillary hemangioma) in 1 case, nasal vestibule angioma (T2N2M0)in 1 case, cancer of hypopharynx (T2N1M0) in 1 case, cancer of amygdale in 3 cases (2 of T2N0M0 and 1 of T3N1M0),cervical segments esophageal carcinoma in 1 case, and cancer of larynx in 4 cases (3 of T2N0M0 and 1 of T3N1M0). Results All these 12 cases were followed up for 6 months. The results of endoscope showed that heterogeneity ADM mingled with mucosa within 3 months after operation and the function was recovered. Pharynx fistula occurred in 1 case of hypopharynx cancer afterthe operation. After treatment of dressing change and antibiotics for 10 days, the wound healed, but after 2 months tumor recurred. All the patients were treated by radiation treatment. One case of amygdala cancer recurred and transferred to the neck after 2 months of radiation treatment. But 1 case of hypopharynx cancer died of massive haemorrhage after radiation treatment for 3 months. Conclusion Heterogeneity ADM can be easily obtained and it is a new method to repair mucosa defect. Theoperative procedure is easy to perform and worthwhile to be appl ied to cl inical operation.
Objective To report the experience of repairingperineal and adjacent defects with thoracoum biblical island flaps. Methods From January 1988 toOctober 2003, 7 cases of perineal and adjacent soft tissue defects with thoracoum biblical island flaps, aged 17-52 years. Of 7 cases, there were 2 cases of severe scar contracture due to burn on perineal, 1 case of malignancy on perineal,4 cases of vast soft tissue defects of trauma on the parts of groin and higher two-third thigh. The area of flaps was 9 cm×27 cm-12 cm×30 cm, the longest pedicel of blood vessel was 16 cm. The donor sites of flaps less than 10 cm couldbe sutured directly, the ones more than 10 cm could be repaired with skin grafting. Results All the flaps primarily survived. There was no ischemia and necrosis atthe distal part of flaps. Four patients were followed up 6 months to 6 years. The color, texture and appearance of the flaps were good. The functions of walk and squat were satisfactory.Conclusion The thoracoum bilical island flap can repair perineal and adjacent soft tissue defects, moreover the donor is shady and the effect is ideal.
Objective To investigate the method and the curative effect of postauricular muscular fasciae-periosteal flap and modified unwrinkle incision in parotidectomy. Methods From January 2006 to August 2008, 28 patients with benign lesions of parotid gland were treated. There were 17 males and 11 females aged 19 to 79 years old (average 50 years old),including 20 cases of mixed tumor, 5 cases of adenolymphoma, 1 case of branchial cleft cyst, 1 case of eosinophil ic hyperplastic lymphogranuloma, and 1 case of myoepithel ioma. Tumor masses were all prominent, with the diameter of 2.4-3.8 cm and partial-tough texture. The course of disease was 3-18 months (average 9.5 months). Parotid gland and tumor mass were resected with postauricular incision hidden within the hairl ine, introcession defect (3.0 cm × 2.0 cm × 1.0 cm-3.5 cm × 2.5 cm × 1.5 cm) were repaired with simultaneouly adopting postauricular muscular fasciae-periosteal flap (4.0 cm × 3.0 cm × 1.0 cm-5.0 cm × 4.0 cm × 1.5 cm) by turning the pedicle flap 180°. Results All incision healed by first intention and no necrosis of postauricular muscular fasciae-periosteal flap occurred. All patients were followed up for 6-24 months (average 12 months). The incision was hidden within postauricular hairl ine and shape of parotid realm was good. No sal ivary fistula, facial paralysis, and earlobe numbness occurred. No Frey syndrome were found by local iodine-starch tests. Conclusion Because of hidden incision, good repair effect of region introcession deformity, and fewer postoperative compl ications, the modified parotidectomy with postauricular muscular fasciae-periosteal flap and modified unwrinkle incision is a better method in parotidectomy.
Omphalocele is a less common congenitalmalformation in neonates and belongs to the realm of emergent surgical treatment. Early repair is of crucial importance for saving the patient s life. Ten neonates with omphalocele have undergone early surgical repair since 1988. The overall result was satisfactory. There were 8boys and 2 girls. The time of operation ranged from one to fortyeight hours after birth (24 hours in 8 cases). All of them were term neonates, except in onecase being premature. None of them had rupture of the sac membrane. The minor and major omphalocele were in 8 and 2 cases, respectively. Five cases accompaniedwith other congenital malformations (1 to 3 kinds). One case of them was complicated by exompholos-macroglossia-gigantism (EMG syndrome). Nine cases were treated by primary stage of surgical repair. One case with major omphalocelehad undergone two-staged operation. Nine neonates were survived and only onedied of pneumonia and scleroderma postoperatively. The patients were followed up for 3 months to 5 years, 9 cases were satisfactory. Early surgical repairwas essential to successful treatment. The choice of surgical methods, the management of concomittant malformation in the alimentary tract and the factors influencing the prognosis were discussed.