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1.
Georgian Med News ; (306): 10-18, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-33130638

RESUMO

Objective - to study the effect of hip contractures on the strength of the thigh muscles. Gait analysis was performed in the OpenSim 4.0 program, gait2394 was taken as the basis. Created 4 models with contractures of varying severity. We analyzed the change in the work of the thigh muscles in normal conditions, with adduction, flexion-adduction and flexion-adduction contractures with shortening. According to the data obtained in modeling the adductive and flexor-adducing contractures of the hip joint, it can be noted that contracture changes the work of the muscles around the hip joint. It was noted that modeling only adduction contracture causes noticeable changes in the medial group of femoral muscles and muscle stabilizers. Of the muscles of the posterior thigh group, m.semimembranosus, m.semitendinosus and m.biceps femoris are most susceptible to changes. These muscles change the level of load, and most importantly, periods of excitation and muscle relaxation shift. Simulation of combined flexion-adduction contracture showed that muscle dysfunctions increase, and m.sartorius, an anterior thigh muscle, was added to the muscles in which noticeable changes additionally occurred. With simulated adduction and flexion adduction contractures, changes occur in all the muscles of the thigh, periods of their excitement and relaxation shift, but the level of muscle tension is close to normal values - not exceeding them by 20-30%. Flexion-leading contracture with shortening of the limb leads to a distortion of muscle parameters in the form of excessive loads for the step (up to 100-300%). Based on the obtained simulation results, the inability of the muscles to develop the necessary efforts leads to a change in the parameters of the step in the form of a decrease in the length of the step and the duration of the periods of support on the foot, a change in the nature of the transfer of the foot. It is logical to assume that a long period of impaired muscle function will lead to the development of sustainable changes in the walking pattern.


Assuntos
Contratura , Articulação do Quadril , Quadril , Humanos , Músculo Esquelético , Coxa da Perna
3.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(10): 1288-1293, 2020 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-33063495

RESUMO

Objective: To explore the suitable division of male genitalia subunits and the effectiveness of large-area perineum defect repair under its guidance. Methods: According to the anatomical and functional characteristics of male genitalia, the subunit division scheme was proposed: area Ⅰ, glans penis; area Ⅱ, body of penis; area Ⅲ, scrotum; area Ⅳ, scrotum. Between April 2017 and July 2019, 12 patients with large genitalia defects were treated, with an average age of 60.9 years (range, 57-66 years) and an average disease duration of 2.7 years (range, 2-5 years). The defect area involved area Ⅰ in 1 case, area Ⅱ in 7 cases, area Ⅲ in 5 cases, and area Ⅳ in 8 cases; the size of area ranged from 6 cm×4 cm to 23 cm×16 cm. The causes of defect included 3 cases of trauma, 6 cases of Paget disease, 2 cases of squamous cell carcinoma, 1 case of spindle cell tumor. According to the design of the corresponding repair scheme, the main repair methods were to rotate and advance the skin flap and pedicled skin flap in the same area. When the defect was large, the free skin flap transplantation, free skin grafting, and free mucosa transplantation were used to repair the defect. Results: All the patients were followed up 6-13 months with an average of 8.6 months. Skin flap, skin graft, and mucosa survived in one stage in 10 patients; infection occurred in 1 case after the scrotal flap of area Ⅲ was transferred to repair the defect in area Ⅱ, 1 case had distal venous crisis at 2 days after repair area Ⅲ defect used free anterolateral thigh flap, and after active treatment, the condition improved. The appearance of the receiving area and the supplying area was good, and the local feeling was recovered satisfactorily. The range of motion of hip joint was good in 10 cases, and 2 cases were slightly stretched but did not affect normal life. All patients had normal urination and defecation function, and were satisfied with the treatment effectiveness. Conclusion: The subunits of male genitalia can be used to guide the repair of the defect, which can better restore the physiological appearance and function, and has positive clinical significance.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Períneo/cirurgia , Transplante de Pele , Lesões dos Tecidos Moles/cirurgia , Coxa da Perna
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 6058-6061, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019352

RESUMO

Chronic pain affects both adolescent and adult Canadians. To study the effect of social rejection on pain management in adolescents with chronic pain, an algometer can be used in conjunction with functional Magnetic Resonance Imaging (fMRI) to measure brain activity in real time. The algometer uses an automated pneumatic control system that follows a customizable pain schedule, controlling the amount of airflow in and out of a pressure cuff wrapped around a human participant's thigh. Plastic components allow compatibility with an fMRI environment. Measurable pain stimuli allow repeatable pressure schedules to be administered with a standard deviation between trials of 300 Pa (2.25 mmHg). A Failure Mode Effects Analysis was used to reduce participant, researcher and facility harm, with multiple safety features incorporated into the design. Through the analysis of medical standards and studies, the algometer is shown to be biologically safe to use on research subjects within the suggested usage parameters of a maximum pressure of 42.6 kPa (320 mmHg) and a pressure application period of up to one hour. This makes it feasible for research studies using fMRI machines.


Assuntos
Dor Crônica , Imagem por Ressonância Magnética , Adolescente , Adulto , Canadá , Humanos , Medição da Dor , Coxa da Perna
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1315-1318, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018230

RESUMO

In clinical practice, doctors usually use computed tomography angiography (CTA) to examine lower extremity atherosclerotic occlusive (ASO). Conveniently and accurately locating occlusive superficial femoral artery (SFA) which is difficult to extract from CTA can facilitate diagnosis and surgery. This paper proposed a method locating the occlusive SFA from CTA conveniently. The proposed method first takes control points at a certain interval to bicubic interpolate, and then feeds image patches generated based on the interpolation results to deep neutral network (DNN) to obtain vessel center points. The final location error is less than 9 pixels, which meets the requirements of clinical assessment accuracy. It can be used to assist the diagnosis and surgery of ASO.


Assuntos
Artéria Femoral , Redes Neurais de Computação , Angiografia , Angiografia por Tomografia Computadorizada , Artéria Femoral/diagnóstico por imagem , Coxa da Perna
6.
Medicine (Baltimore) ; 99(43): e22810, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120802

RESUMO

RATIONALE: Myositis ossificans (MO) is a benign condition characterized by heterotopic bone formation in the skeletal muscle of extremities. Marked variation can occur in the incidence and location of the bone formed as well as resulting complications. Femoral vessel obstruction caused by MO is an extremely rare but disabling complication. Arterial occlusion may aggravate ischemic conditions, resulting in necrosis in the lower extremity. PATIENT CONCERNS: We report a 41-year-old female with progressive pain and swelling of the right thigh region for 1 year. DIAGNOSES: We diagnosed it as obstruction of the superficial femoral artery and vein caused by external compression of the MO between the sartorius and vastus medialis of the thigh. INTERVENTIONS AND OUTCOMES: Adherent tissues and mass were excised with care without damaging the femoral artery or the vein. However, normal morphology did not recover due to loss of elasticity of femoral vessels. Therefore, after resection of the narrowed region of the femoral artery, a femoral-to-femoral graft interposition using the greater saphenous vein was performed. At 12 months after the surgery, vessel reconstruction computed tomography images confirmed normal continuous flow of the femoral artery. LESSONS: Vascular compression and peripheral inflammatory response due to MO can cause loss of normal vascular morphology. Surgical excision of the mass and the involved femoral artery segment followed by femoral arterial reconstruction should be considered for lesions that do not spontaneously regress to prevent functional impairment and secondary complications in extremities.


Assuntos
Artéria Femoral/patologia , Veia Femoral/patologia , Miosite Ossificante/complicações , Doenças Vasculares Periféricas/etiologia , Coxa da Perna/patologia , Adulto , Constrição Patológica , Feminino , Humanos , Miosite Ossificante/cirurgia , Coxa da Perna/cirurgia , Procedimentos Cirúrgicos Vasculares
7.
Medicine (Baltimore) ; 99(37): e22120, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925760

RESUMO

The purpose of this study is to study sonoelastographic features of the saphenous nerve.The study included 72 saphenous nerves in 36 healthy subjects. High resolution ultrasound and Shearwave elastography were used to evaluate the saphenous nerve. Cross sectional area (CSA) and stiffness were measured.The mean CSA of the saphenous nerve was 5.7 mm. The mean shear elastic modulus of the saphenous nerve in the short axis was 29.5 kPa. The mean shear elastic modulus of the saphenous nerve in long axis was 29.9 kPa. The saphenous nerve elastic modulus also showed no correlation with CSA in neither the long axis nor short axis. Positive correlation between elasticity measurements in the long and short axes. Age, height, weight, and BMI showed no correlation with saphenous nerve elastic modulus in short or long axes.The elastic modulus of the saphenous nerve has been determined in healthy subjects and can serve as a reference for future assessment of the saphenous nerve before different procedures.


Assuntos
Técnicas de Imagem por Elasticidade , Elasticidade/fisiologia , Nervos Periféricos/diagnóstico por imagem , Nervos Periféricos/fisiologia , Coxa da Perna/inervação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Coxa da Perna/diagnóstico por imagem , Adulto Jovem
8.
J Sports Sci ; 38(19): 2200-2207, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32921248

RESUMO

The aims of this study were (a) to describe the kinematics underlying the phenomenon of the knee of the swing leg passing medially in front of the athlete during the single push (SP) phase of the block sprint start, and (b) to determine the relationships between block phase pelvis range of motion (RoM), 1st step width and block phase performance. Three-dimensional kinematic data (250 Hz) were collected from eleven competitive sprinters (100 m PB: 11.17 ± 0.41) performing maximal effort block starts. The joint angles of the rear hip with respect to the pelvis and the pelvis segment angles with respect to the laboratory coordinate system were calculated during the block start phase to the end of the 1st stance. A combination of pelvis list and rotation (not hip adduction) was coupled with the thigh of the swing leg moving medially during the SP phase. A very high positive correlation was found between pelvic list RoM and 1st step width (r = 0.799, p = 0.003). No other significant correlations were found. Attempting to reduce pelvic RoM or changing frontal and transverse plane hip joint angles to minimise medial thigh motion is unlikely to lead to an improvement to performance.


Assuntos
Articulação do Joelho/fisiologia , Pelve/fisiologia , Corrida/fisiologia , Aceleração , Fenômenos Biomecânicos , Feminino , Análise da Marcha , Articulação do Quadril/fisiologia , Humanos , Masculino , Postura/fisiologia , Amplitude de Movimento Articular , Coxa da Perna/fisiologia , Estudos de Tempo e Movimento , Adulto Jovem
9.
Am J Phys Med Rehabil ; 99(10): 902-908, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32941253

RESUMO

OBJECTIVE: The aim of the study was to explore an individualized sonographic muscle thickness ratio and its cutoff values in the diagnosis of sarcopenia. DESIGN: A total of 326 community-dwelling adults were included in this cross-sectional study. Total skeletal muscle mass was evaluated by bioelectrical impedance analysis, and nine-site muscle thickness measurements using ultrasound. Isometric handgrip and knee extension strengths were assessed. Physical performance was evaluated by usual Gait Speed, Chair Stand Test, and Timed Up and Go Test. RESULTS: Because the anterior thigh muscle thickness was the most significantly decreasing measurement with aging and the most significantly related value with body mass and height; sonographic thigh adjustment ratio was calculated by dividing it with body mass index. Using the two standard deviation values of our healthy young adults, sonographic thigh adjustment ratio cutoff values were found as 1.4 and 1.0 for male and female subjects, respectively. Sonographic thigh adjustment ratio values were negatively correlated with Chair Stand Test and Timed Up and Go Test in both sexes (all P < 0.05) and positively correlated with gait speed in female subjects and knee extension strength in male subjects (both P < 0.05). CONCLUSIONS: Our results imply that regional (rather than total) muscle mass measurements should be taken into consideration for the diagnosis of sarcopenia.


Assuntos
Sarcopenia/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diagnóstico Diferencial , Impedância Elétrica , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia
10.
J Craniomaxillofac Surg ; 48(11): 1066-1073, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32994154

RESUMO

Aim of the study was to compare perforator vessel location using color-coded Doppler ultrasound and hyperspectral imaging in the area of the antero-lateral thigh. In a cross-sectional case-control study, the bilateral antero-lateral thigh region was examined for perforator vessel location via color-coded Doppler ultrasound (control) and hyperspectral imaging (test). For hyperspectral imaging, all measurements were conducted without cooling (T0) and after 1 (T1), 2 (T2) and 3 min (T3) of cooling. Additionally, in the reperfusion period after cooling, hyperspectral imaging was conducted at 1, 2 and 3 min (T4/T5/T6). Results from color-coded Doppler ultrasound and hyperspectral imaging were matched at all time points (T0-T6). In total, 71/73 perforator vessel locations could be matched (sensitivity: 97%). Matching of color-coded Doppler ultrasound and hyperspectral imaging was significantly influenced by the cooling protocol and the highest matching values were seen at T3 (3 min cooling; 60 perforator vessels) and T4 (3 min cooling & 1 min reperfusion; 62 perforator vessels) without significant differences (sensitivity 98%; p = 0.9). There were significant differences between T4 and T0, T1 (both p < 0.001), T5 (p = 0.045) and T6 (p = 0.012). For clinical proof of concept, a patient case using a free antero-lateral thigh flap for reconstruction of a facial defect after perforator vessel identification via color-coded Doppler ultrasound and hyperspectral imaging (3 min cooling & 1 min reperfusion) was carried out successfully. In conclusion, hyperspectral imaging potentially offers an additional opportunity for non-invasive, user-independent perforator-site assessment if prior cooling of the site is conducted.


Assuntos
Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Estudos de Casos e Controles , Estudos Transversais , Estudos de Viabilidade , Humanos , Coxa da Perna/diagnóstico por imagem , Coxa da Perna/cirurgia
11.
J Spec Oper Med ; 20(3): 52-61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969004

RESUMO

BACKGROUND: The OMNA Marine Tourniquet is a 5.1cm-wide, simple redirect buckle, hoop-and-loop secured, ratcheting tourniquet designed for storage and use in marine environments. This study evaluated self-application effectiveness and pressures. METHODS: Triplicate secured, occlusion, and completion pressures were measured during 60 subjects pulling down or up thigh applications and nondominant, single-handed arm applications. Arm pressure measurements required circumferences =30cm. RESULTS: Thirty-one subjects had arm circumferences ≥30cm. All 540 applications were effective; 376 of 453 applications had known secured pressures >150mmHg (89 of 93 arm). Thigh down versus up pulling directions were not different (secured, occlusion, and completion pressures and ladder tooth advances). Occlusion pressures were 348mmHg (275-521mmHg) for combined thighs and 285mmHg (211-372mmHg) for arms. Completion pressures were 414mmHg (320-588mmHg) for combined thighs and 344mmHg (261-404mmHg) for arms. Correlations between secured pressures and occlusion ladder tooth advances (clicks) were r2 = 0.44 for combined thighs and 0.68 for arms. Correlations between occlusion pressures and occlusion clicks were poor (r2 = 0.24, P < .0001 for combined thighs and r2 = 0.027, P = .38 for arms). CONCLUSIONS: The OMNA Marine Tourniquet can be self-applied effectively, including one-handed applications. Occlusion and completion pressures are similar to reported 3.8cm-wide Ratcheting Medical Tourniquet pressures.


Assuntos
Torniquetes , Braço , Mãos , Humanos , Pressão , Coxa da Perna
13.
J Surg Oncol ; 122(4): 632-638, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32830325

RESUMO

BACKGROUND AND OBJECTIVES: Aggressive resection of buccal cancer simultaneously leaves both oral and lateral facial defects. It is unknown whether a perforator-based chimeric anterolateral thigh (ALT) flap, with a muscular component, is suitable for the reconstruction of these complicated defects. METHODS: In this retrospective study, 48 patients with a buccal carcinoma (T2 N0-1 M0), who underwent extensive surgical resection, were enrolled. Twenty-seven cases underwent reconstruction using the classical ALT perforator flap (classical group), and 21 cases used the chimeric ALT perforator flap with vastus lateralis muscle mass (chimeric group). The incidence of wound infection, lower limb extremity function, facial appearance, survival curves, and quality of life were compared between groups. RESULTS: The incidence of wound infection or effusion was lower in the chimeric group than in the classical group. The aesthetic result achieved in the chimeric group was better than in the classical group. Meanwhile, there was no significant difference in the function of the donor site between groups. CONCLUSIONS: The chimeric ALT perforator flap, with a muscular component, can reconstruct both the oral and lateral face defects accurately. It sustains the profile of the lateral face and decreases the incidence of wound infection.


Assuntos
Carcinoma/cirurgia , Neoplasias Bucais/cirurgia , Retalho Perfurante , Músculo Quadríceps/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Coxa da Perna/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/epidemiologia , Resultado do Tratamento
14.
Unfallchirurg ; 123(9): 694-704, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32737514

RESUMO

BACKGROUND: Pseudarthrosis can develop as a complication after conservative or operative fracture treatment and after elective orthopedic surgery. The treatment is challenging and is made more difficult when accompanied by large soft tissue defects or impairments in wound healing. In this case close and early coordination between trauma and plastic surgeons is crucial in order to develop a coherent and interdisciplinary treatment plan. METHODS: Due to the positive effects on bone consolidation and osteomyelitis, timely soft tissue reconstruction via a pedicled vascularized flap or free flap coverage should be preferred. If blood circulation in the affected extremity appears to be compromised, this should first be optimized by vascular intervention or bypass surgery. In atrophic, aseptic pseudarthrosis, bone and soft tissue reconstruction can be performed consecutively in one single procedure, whereas septic pseudarthrosis always require complete resection of all infected debris prior to wound closure. Examples of two commonly used free flaps are the latissimus dorsi muscle flap and the fasciocutaneous anterolateral thigh (ALT) flap. As multiple variations have been described for both procedures, the reconstructive portfolio lists many additional options available for soft tissue reconstruction. Fasciocutaneous flaps should be preferred whenever bone consolidation requires additional surgical interventions in the future.


Assuntos
Retalhos de Tecido Biológico , Pseudoartrose , Procedimentos Cirúrgicos Reconstrutivos , Humanos , Pseudoartrose/cirurgia , Coxa da Perna , Cicatrização
15.
Artigo em Chinês | MEDLINE | ID: mdl-32791594

RESUMO

Objective:To explore the application value of anteromedial thigh flap(AMT) as alternative flap in repairing maxillofacial soft tissue defects. Method:Sixty patients were scheduled to underwent anterolateral thigh flap(ALT) reconstruction. Preoperative CT angiography were conducted. Imaging workstations were used to locate perforator vessels in the anterolateral and anteromedial areas respectively. Four patients had no suitable perforator during the preparation of AMT flaps. In the same operation area, ALT flaps were prepared to reconstruct the defect according to the location of the perforator vessels in the anteromedial areas. Result:All four AMT flaps survived uneventfully. Flap sizes ranged from 9 cm×6 cm to 7 cm×4 cm. The follow-up period ranged from 6 to 12 months, the functions of recipient and donor sites recovered well. Conclusion:Preoperative CT angiography can improve the accuracy of the preparation of skin flap effectively. When no sizable perforator is available during harvest of the ALT flap, successful reconstruction can be achieved using the ipsilateral AMT flap.


Assuntos
Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles/cirurgia , Humanos , Transplante de Pele , Coxa da Perna/cirurgia
17.
Zhonghua Shao Shang Za Zhi ; 36(8): 730-734, 2020 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-32829614

RESUMO

Objective: To explore the clinical effects of individualized free anterolateral thigh flap in repairing complex refractory wound. Methods: From July 2015 to May 2019, 19 patients with complex refractory wounds were hospitalized in Yulin NO.1 People's Hospital of Guangxi Zhuang Autonomous Region, including 12 males and 7 female, aged 13-67 years. There were 5 patients with multiple tissue defects, 7 patients with large area of wounds, and 7 patients with wounds in special areas. The sizes of wounds after complete debridement were 8 cm×5 cm-23 cm×7 cm. According to the repair demand, the wounds in 5 patients were repaired with anterolateral thigh flaps and flow-through, the wounds in 7 patients were repaired with anterolateral thigh flaps chimed with lateral thigh muscle flaps, with vascular anastomosis in 2 patients, the wounds in 6 patients were repaired with unilateral anterolateral thigh lobulated flaps, and the wound in 1 patient was repaired with bilateral anterolateral thigh flap in series connection. The sizes of flaps were 10 cm×7 cm-25 cm×9 cm. The donor sites were sutured directly or repaired with thin split-thickness skin graft of head. The survival of the flaps, the appearance of the donor sites, and wounds repair after the operation and during follow-up were observed. Results: The lobulated flap in 1 patient had local necrosis after the operation and finally healed by debridement, dressing change, and transplanting medium split-thickness skin graft in groin. The flaps in 18 patients survived with good blood supply, and the lobulated flap tissue was swollen in 1 of 18 patients. The donor sites which were directly sutured in 18 patients only had linear scar, and the donor site which was repaired with thin split-thickness skin graft of head in 1 patient had flaky scar. Follow-up of 1-12 months showed that all the wounds healed well, the flap thinning operations were performed in 5 patients in 3 months post operation because the flaps were slightly bloated. The CT angiography after the operation showed that the anastomosed blood vessels were unobstructed in 7 patients with reconstructed local blood supply. Conclusions: The special forms of anterolateral thigh flap, such as lobulation, series connection, and chimerism can be designed according to the anatomical characteristics of the descending branch of the lateral femoral artery to meet individualized repair demand for complex refractory wounds, and achieve the double purposes of making full use of the donor site tissue and good repair of the recipient site.


Assuntos
Retalhos de Tecido Biológico , Coxa da Perna/cirurgia , Adolescente , Adulto , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Recidiva , Transplante de Pele , Lesões dos Tecidos Moles , Resultado do Tratamento , Adulto Jovem
18.
Zhonghua Shao Shang Za Zhi ; 36(8): 738-742, 2020 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-32829616

RESUMO

Objective: To explore the effects of pedicled anterolateral thigh flaps in repairing skin and soft tissue defects in perineal region caused by necrotizing fasciitis. Methods: From March 2014 to December 2018, 6 patients with skin and soft tissue defects in perineal region caused by necrotizing fasciitis were admitted to Department of Burns of Hanzhong Central Hospital (hereinafter referred to as our hospital). Two female patients had labia major defects and 4 male patients had scrotum defects, with age of 43-68 years. The areas of skin and soft tissue defects after debridement were 4%-8% total body surface area. The wounds in non-joint and non-functional area were repaired with free split-thickness skin grafts from medial femoral region, and the residual wounds areas in perineal region after repair were 10 cm×4 cm-22 cm×10 cm, which were repaired with pedicled anterolateral thigh flaps, with area of 12 cm×5 cm-24 cm×12 cm. The secondary wounds in the donor sites were sutured directly or repaired with free split-thickness skin grafts from medial thigh on the same or opposite side of the wounds. The bacterial culture result of wound exudate, drug sensitivity test result, and blood bacterial culture result on admission were recorded. The postoperative flap survival was observed. The length of hospital stay, debridement times, and antibiotics use time were recorded. The flap swelling condition was observed to evaluate whether flap thinning operation was necessary, the sensory recovery of the flap and hip joint activity were evaluated, and the scrotum function of male patients was evaluated by urologist in our hospital during follow-up. Results: The bacterial culture results of wound exudate in 5 patients on admission showed Escherichia coli with 4 of them having the same bacteria and the other one having methicillin-resistant Staphylococcus aureus detected in their blood samples. All the flaps survived in 6 patients after the operation, with total length of hospital stay of (22±5) d, debridement of 3-5 times, and antibiotics use time of (13±3) d. During follow-up of 3 to 6 months after the operation, the flaps were slightly bloated in 2 patients, and the flap thinning operation was performed 6 months after wound repair. The sensory function recovered to normal in 2 flaps of patients with anterolateral femoral cutaneous nerve, and the superficial sensory function in the other flaps of patients recovered in different degrees.The hip joint activity was close to normal in all the patients, and the scrotum function was normal in 4 male patients. Conclusions: The pedicled anterolateral thigh flap showed good effects in repairing skin and soft tissue defects on perineal region caused by necrotizing fasciitis, with good appearance and function after operation, and the method is simple, safe, and easy to apply.


Assuntos
Fasciite Necrosante , Coxa da Perna , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina , Procedimentos Cirúrgicos Reconstrutivos , Transplante de Pele , Lesões dos Tecidos Moles , Resultado do Tratamento
19.
Vasc Endovascular Surg ; 54(8): 752-755, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32783501
20.
Biomed Environ Sci ; 33(7): 510-517, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32807270

RESUMO

Objective: The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns. Methods: We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018. The clinical and pathological data were extracted from electronic hospital medical records. We obtained follow-up information through clinic visits. Results: The injury sites for all 8 patients were the wrists, specifically 5 right and 3 left wrists, all of which were on the flexor side. Five patients had ulnar artery embolism necrosis and patency, with injury to the radial artery. Two patients had ulnar and radial arterial embolization and necrosis. The last patient had ulnar arterial embolization and necrosis with a normal radial artery. After debridement, the wound area ranged from 12 cm × 9 cm to 25 cm × 16 cm. The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns. Free flow-through anterolateral thigh flaps (combined with great saphenous vein transplantation if necessary) were used to repair the wounds. The prognosis for all patients was good after six months to one year of follow-up. Conclusion: Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice. The use of free flow-through anterolateral thigh flaps (combined with great saphenous vein transplantation if necessary) to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns.


Assuntos
Queimaduras por Corrente Elétrica/cirurgia , Retalhos Cirúrgicos/estatística & dados numéricos , Coxa da Perna , Cicatrização , Traumatismos do Punho/cirurgia , Adulto , Pequim , Humanos , Masculino , Estudos Retrospectivos , Adulto Jovem
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