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Objective:To introduce a surgical method and clinical effect of using Masquelet technique combined with skin graft to cover chronic refractory wounds in elderly patients.Methods:From September 2020 to September 2022, 20 elderly patients with wounds of bone or tendon exposure in lower limbs were treated in the Department of Wound Repair, the Second Affiliated Hospital of Wenzhou Medical University. Due to the age and poor general condition of the patients, flap transfer for wound coverage were not allowed. Masquelet technique was therefore applied in the treatment of chronic wounds of such patients. Sizes of wounds were found at 4.5 cm×3.0 cm to 15.0 cm×6.0 cm and all accompanied with tendon and bone exposure, after thorough debridement. Wounds were then sealed with antibiotic bone cement several times. After having induced formation of membrane in wounds, free mesh skin graft was used to cover the refractory wounds. The patients were entered in follow up regularly after surgery at outpatient service, and telephone or video reviews. The wound healing of patients and whether there were related complications in the skin donor area were observed. The number of operation times in the first stage was 1-4 with an average of 1.3 times ± 0.7 times. Lower Extremity Function Scale (LEFS) was used to evaluate the recovery of lower limb function.Results:All 20 wounds healed well. The follow-up time was 3-12 months, with an average of 7.6 months. The appearance and texture of the skin in the wounds area were satisfactory. The mean LEFS was 69.83 point ± 10.82 point.Conclusion:Using Masquelet technique combined with free skin grafting to treat refractory wounds in the elderly patients can achieve satisfactory clinical outcomes. It is a simple and reliable supplement to the wound repair, and can reduce the surgical risk.
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<p><b>OBJECTIVE</b>To summarize the experience of repairing of severely burned hand and wrist with abdominal thin skin flaps in insertion pattern.</p><p><b>METHODS</b>Twelve burn patients with the dorsum of the hands and wrist being severely injured were enrolled in this report. The donor sites of the flaps were selected on the upper abdomen in 4 cases and on the lower abdomen in 8 cases. The division of the flap pedicles was done on the 10th - 13th postoperative days.</p><p><b>RESULTS</b>All the flaps survived except that there were two necrotic areas sized 2 cm x 2 cm and 1 cm x 1 cm, respectively, on the distal ends of the flaps in two cases. The hand function and contour recovered satisfactorily after the operation.</p><p><b>CONCLUSION</b>It could be an ideal choice for the repair of severely burned hand and wrist with abdominal thin skin flaps.</p>
Subject(s)
Adult , Female , Humans , Male , Abdomen , Burns , General Surgery , Hand Injuries , General Surgery , Skin Transplantation , Methods , Time Factors , Wound Healing , Wrist Injuries , General SurgeryABSTRACT
Objective To investigate the role of immune response induced by different T-helper 1 and T-helper 2 (Th1 and Th2) ratio in peripheral blood and decidua from patients with hypertensive disorder complicating pregnancy in the pathogenesis of the disease. Methods Peripheral blood and decidua from 12 non-pregnant women (no deciduas)(normal women group), 12 healthy pregnant women(healthy pregnant women group), 10 patients with gestational hypertension(gestational hypertension group), 25 patients with pre-eclampsia (PE)(including 10 patients with mild pre-eclampsia and 15 patients with severe pre-eclampsia)(pre-eclampsia group). Th1/Th2 ratio in peripheral blood and decidua was determined by flow-cytometrically. Results The ratio of Th1/Th2 in peripheral blood with normal women group is 10.5?1.5, the ratios of Th1/Th2 in peripheral blood and deciduas with healthy pregnant women group are 9.5 ?2.9 and 7.6?4.6 respectively, those with gestational hypertension group are 12.1?3.4 and 13.1?5.6 respectively, those with pre-eclampsia group are 16.8?3.8 and 26.7 ?9.4 respectively. The ratios of Th1/Th2 in peripheral blood and deciduas with pre-eclampsia group are much higher than those with other groups!, when they are compared with each other, there are statistical difference(P
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OBJECTIVE To know the pathogens distribution and resistance situation in the burn wards.METHODS A retrospective analysis was conducted to 627 pathogen isolates and sensitivity results,which submitted by burn department from May 2005 to May 2008.RESULTS Gram-negative(G-) bacilli occupied for 33.8%,Gram-positive(G+) cocci occupied for 48.8% and fungi occupied for 17.4%.Acinetobacter baumannii occupied for 8.6%,Pseudomonas aeruginosa occupied for 6.0%,Staphylococcus aureus occupied for 77.5%,in which the isolation rate of meticillin-resistant S.aureus(MRSA) was 94.9%.The drug sensitivity tests showed that various detectable bacteria possessed multi-drug resistance;G+ bacteria were sensitive to vancomycin,G-were sensitive to imipenem,but only A.baumannii was sensitive to cefoperazone/sulbactam.CONCLUSIONS The bacterial infection in the burn department in our hospital mainly is due to G+ cocci,then is G-bacilli,from which the A.baumannii detection rate is increasing.Clinicians should enhence to detect the sensitivity of bacteria and use antibiotics reasonably.