Objective To investigate the effectiveness of nasolabial flap and ear cartilage in repairing defects after nasal ala basal cell carcinoma resection. Methods Between January 2012 and August 2014, 8 patients with nasal ala basal cell carcinoma underwent tumor resection?and defect repair with nasolabial flap and ear cartilage. Among the 8 patients, 5 were male and 3 were female, with an average age of 65 years (range, 45-76 years). The left side and right side were involved in 3 cases and 5 cases respectively. Carcinoma confirmed by pathological examination in all patients. The time between first biopsy and resection was 7-14 days (mean, 10 days). The defect ranged from 1.5 cm×1.5 cm to 2.0 cm×1.5?cm after tumor resection, and the size of nasolabial flaps ranged from 4.0 cm×1.5 cm to 5.0 cm×2.0 cm. The operations of cutting off the pedicle and thinning skin flap were performed at 6 months after first operation. Results All flaps survived. Incisions healed by first intention, and no related complication occurred. No carcinoma recurred after cutting off the pedicle. All patients were followed up for 6 months. All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, and no obvious scar. Conclusion Nasolabial flap transfer and ear cartilage transplant method not only can repair the nasal ala defects, but also can avoid obvious scar and obtain good nasal ala contour profile. The shortcoming is that patients have to receive two operations.
【Abstract】 Objective To investigate the effects of different surgical methods in treating scalp mal ignanttumors. Methods From January 1995 to September 2004, 70 patients with scalp mal ignant tumor were treated with different surgical methods. There were 41 males and 29 females with an average age of 50.3 years (30-85 years). The course of disease ranged from 2 weeks to 3 years(mean 3.5 months). There were 31 cases of basal cell carcinoma, 24 cases of squamous carcinoma, 8 cases of melanocarcinoma, 4 cases of fibrous sarcoma, 2 cases of l iposarcoma, and 1 case of vasculosarcoma. Leision size ranged from 1.0 cm × 0.5 cm to 10.0 cm × 8.0 cm. Scalp defect ranged from 3 cm × 3 cm to 12 cm × 11 cm after clearing up the tumors. Defect was repaired with free skin transplantation in 51 cases, scalp flap in 12 cases, cervico-shoulder flap in 2 cases, trapizius myocutaneous flap in 3 cases, and radial artery retro-island flap in 2 cases. The flap sizes ranged from 5 cm × 4 cm to 18 cm × 12 cm. Results Of 70 cases, 67 skin flaps survived and incision healed by first intention; 2 flaps necrosed at distal part(lt; 1 cm) and healed by second intention after dressing change; 1 flap infected and was treated with symptomatic medication.All the donor sites healed by first intention. Fifty-five patients were followed up for 1 to 5 years and 5 cases had tumor recurrence. In patients receiving skin transplantation, 1 case of squamous carcinoma and 1 case of fibrous sarcoma relapsed after 1 year and 2.5 years respectively and were given radical resection and skin flap grafting; in patients receiving skin flap grafting, 1 case of vasculosarcoma and 1 case of squamous carcinoma relapsed after 6 months and 3 months respectively, and gave up treatment; 1 case of fibrous sarcoma relapsed after 2 years and was given radical resection and skin flap grafting. The other cases survived and had no tumor recurrence. Conclusion Scalp mal ignant tumors should be diagnosised and treated as early as possible. Clearing up completely by surgery is an effective method.
Objective To summarize the prevention and treatment of postoperative complications after the skin soft tissue expansion for scar alopecia. Methods From January 1995 to June 2005, 57 patients with scar alopecia were admitted to our department for treatment. Of the patients, 25 were males and 32 were females with their ages ranging from 5 to 55 years. The causes were burn in 33 patients, trauma in 14, alopecia after head surgery in 8, and other causes in 2. Their disease courses ranged from 6 months to 15 years. Fortreatment, 89 therapeutic expanders were utilized in 57 patients. The retrospective analysis on the complications and their prevention and treatment were performed. Results The follow-up for 3-12 months averaged 6 monthsrevealed that 81 areas undergoing the expander insertion healed well and the hair grew well, too. Eight areas undergoing the expander insertions had complications, including expander exposure in 2 patients, infection in 2, hematoma in 1, expander rupture in 1, necrosis of the flap tip in 1, and scar necrosis at the injection port in 1. The results also revealed that there was a significantly increased rate of complications in the patients aged 5-10 years and the patients older than 50 years （Plt;0.05）. The complication rate in the patients who received 2 expanders at one time was significantly higher than that in the patients whoreceived only 1 expander（Plt;0.05）. However, there was no significant difference in the complication rate in the other kinds of patients. All the complicationswere effectively treated with a satisfactory therapeutic result. Conclusion The skin soft tissue expansion for scar alopecia can effectively prevent and treat postoperative complications. If the complications are identified early and treated properly, the therapeutic results will be satisfactory.
目的：探討電擊傷的臨床特征，手術治療及療效。方法：對78例電擊傷患者的臨床資料進行分析。結果：電擊傷多為工傷，病情重，常常多次手術，住院時間長，致殘率高。結論：早期積極、延遲的手術，功能可得到最大的恢復，截肢率降低，預后較好；電擊傷創面修復以皮瓣、肌皮瓣轉移的手術方式效果為佳。
ObjectiveTo investigate the effectiveness of double buried suture method for correction of secondary mild unilateral cleft lip nose deformity. MethodsBetween June 2010 and June 2012, 20 patients with secondary mild unilateral cleft lip nose deformity were treated with double buried suture method. Among 20 patients, 12 were male and 8 were female, with an average age of 21 years (range, 14-44 years). All patients had unilateral cleft lip nose deformity after unilateral cleft lip repair, including 9 cases of left deformity and 11 cases of right deformity. The time between first repair and double buried suture was 11-42 years (mean, 19 years). ResultsIncisions healed by first intention, and no related complication occurred. The patients were followed up 6-12 months (mean, 8 months). All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, a central columella, symmetry of nasal floor, and no obvious scar. No recurrence was observed during follow-up. ConclusionDouble buried suture method not only can correct secondary mild unilateral cleft lip nose deformity completely, but also can avoid obvious scarring and recurrence of nose deformity.
目的：探討N-乙酰半胱氨酸對燙傷大鼠炎癥反應的影響。方法：48只Wistar大鼠隨機分為實驗組和對照組，制作燙傷休克模型，傷后1小時腹腔注射生理鹽水40ml/kg抗休克，實驗組于抗休克鹽水中加入N-乙酰半胱氨酸160mg/kg，其后足量飲水。分別于燙傷前、燙傷后8小時、16小時及24小時，處死每組各6只大鼠并立即心臟取血，采用ELISA法檢測大鼠血清中TNF-a含量，于創周近頭側 0.5cm處取皮膚全層組織，在顯微鏡下進行中性粒細胞計數。 結果：兩組大鼠血清TNF-a含量傷后顯著升高，8小時達到高峰，其后逐漸下降，兩組各時點比較有顯著差異（P＜0.05）；創周組織中性粒細胞計數于傷后隨時間延長逐漸增多，兩組比較有顯著性差異（P＜0.05）。 結論：N-乙酰半胱氨酸有助于降低燙傷大鼠血漿中TNF-a含量及創周組織中的中性粒細胞計數量，減輕燙傷大鼠的全身及局部炎癥反應。
Objective To summarize the treatment of chronic osteomyel itis of the skull and its effectiveness. Methods Between January 2004 and February 2009, 24 patients with chronic osteomyel itis of skull were diagnosed and treated, including 16 males and 8 females with an average age of 45.6 years (range, 18-56 years). The mean disease duration was 5.8 years (range, 3-11 years). The causes included infection after craniotomy in 3 cases, burn in 15 cases, and electrical injury in 6 cases, and the leision was located at the frontal and parietal of the skull in 10 cases, at the temporal and parietal of skull in 8 cases, and at the occipital of the skull in 6 cases. The soft tissue defects ranged from 7 cm × 6 cm to 19 cm × 12 cm, and the skull defects ranged from 5 cm × 4 cm to 10 cm × 7 cm. After wide thorough debridement of necrotic tissue, soft tissue defects were repaired with adjacent scalp flap in 12 cases, trapezius myocutaneous flap in 6 cases, and free anterolateral thigh flap in 6 cases; the flap size ranged from 8 cm × 7cm to 20 cm × 13 cm. The donor sites were sutured directly or covered with spl itthickness skin. Results All pathological examinations showed pyogenic osteomyel itis of the skull, and local ized squamous carcinoma was found in 1 case. One patient had sub-flap infection at 2 weeks after operation, and heal ing was achieved after surgical removal of residual tissue; the remaining flaps survived, and incision healed by first intention. All patients were followed up 10 months to 4 years with an average of 2 years after operation. The color and texture of the flaps were good. No recurrence of osteomyel itis happened during follow-up. The patient diagnosed as having local ized squamous carcinoma was followed up 4 years without recurrence. At 3 to 6 months after operation, 8 patients had headache or felt dizzy, and the skull was reconstructed by the titanium meshes. Conclusion In patients with chronic osteomyel itis of skull, the infected foci should be cleaned out thoroughly as early as possible, and the skin flap or myocutaneous flap is used to repair the wounds, thus the good results can be achieved.