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Wysłany: Śro 17:00, 20 Kwi 2011 Temat postu: polo outlet online Full-thickness skin excision of |
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Key words full-thickness excision of lesion; skin replantation; lymphedema
1.2 preoperative preoperative MRI, bilateral X film examination,[link widoczny dla zalogowanych], the patient bed rest, Taigaohuanzhi, external elastic bandage wrap 10 ~ 14 d, to give way during massage, to promote retention lymph return, in order to improve the nutritional status of the skin; and 1:1 000 with soapy water and benzalkonium bromide solution daily cleaning limb, to be dressing for ulcers,[link widoczny dla zalogowanych], try to promote wound healing after surgical treatment.
1.3 surgical procedures under anesthesia to determine the lesion, surgery under tourniquet. As appropriate according to the specific lesion under the incisions until the deep fascia, thickening of the skin and subcutaneous tissue fibrosis in the muscle membrane outside the en bloc resection, but also part of the proliferation of sarcolemma resectable. Dorsum of the foot, ankle and Achilles tendon lesions on both sides must be completely removed to prevent lymphatic leakage caused by skin graft necrosis. Dressing over the wound with warm salt water, release the tourniquet, hemostasis, and hydrogen peroxide solution, 1:1 000 benzalkonium bromide solution and repeatedly washed with normal saline, and saline wet dressing with gentamicin. The entire organization will cut the skin with a knife to take anti-drum perfecting skin graft taken to select good quality part of the replantation in the wound. Back when the skin graft skin graft pieces with attention to maintaining proper tension to ensure good healing of skin graft. Tarpaulin and gentamicin with Vaseline gauze wet with normal saline wet dressing, sterile gauze pressure bandage. Postop Taigaohuanzhi, 10 d after the open dressing dressing, 12 d after the removal of stitches. Routine use of antibiotics to prevent infection after surgery, attention to nutrition support therapy. Wear elastic sleeve after wound healing, gradually activities, adjusted according to the situation every time elastic sleeve.
how to treat lymphedema remains a clinical problem more difficult [1]. While some non-surgical therapy has achieved some results, but there are still some patients the disease will inevitably increase,[link widoczny dla zalogowanych], and ultimately the formation of elephantiasis leg requiring surgery. Our hospital from 2002 -2007 as the skin on the legs for the 18 cases were operated with a full thickness resection of lesions, in situ full-thickness skin grafting, and achieved satisfactory results, are reported below.
1.1 General information 20 patients in this group of 8 males and 12 females; aged 9 to 50 years old, average 33.2 years old. Course of 8 to 42 years, average 23.1 years. In accordance with international grading standards are severe lymphedema. Lesion of left upper and right lower extremity in 2 cases, left forearm in 3 cases, 2 cases of right forearm, right leg in 3 cases, 5 cases of unilateral leg and foot, unilateral thigh, leg and foot in 5 cases. Causes are congenital lymphatic hypoplasia, patients with local non-filariasis popular. Of which 9 patients had non-surgical therapy for years with poor results, 6 patients had partial suture line, 5 patients had never been treated lesions have a high degree of fibrosis.
Abstract: Objective To investigate the effect of operative treatment on severe extremity lymphedema.Methods We used the operative treatment meothod of excision of the whole lesion in conjunction with skin replantation in 20 cases of severe refractory extremity lymphedema.Results The thick deformed limbs were obviously shrunk, and thEir limb functions were markedly improved. All the patients have stable effects during 6 to 36 months 'follow up.Conclusion The operative method of excision of the whole lesion in conjunction with skin replantation has a notable curative effect.
1 Materials and methods
Key words: excision of the whole lesion; skin replantation; lymphedema
2 the results of 17 patients in this group all survived the chip skin grafting, skin grafting partial necrosis in 3 cases, before making full-thickness skin graft to heal. Followed up for 6 months to 3 years to eliminate limb lymphedema, circumference was significantly reduced, close to the contralateral limb, the skin soft, flexible, good physical activity, the patient conscious activity easily.
Resection and full thickness skin lesions in severe replantation treatment of lymphedema
Of: Yongqing Chang, Jian-Xing, business Huijuan, Carefree
Abstract Objective To explore a heavy limbs, surgical treatment of lymphedema. Methods 20 patients with refractory, giant elephantiasis patients, combined with excision of lesion of skin wounds way back to the treatment plant. Results deformities,[link widoczny dla zalogowanych], huge limb was significantly reduced, limb function improved, the effect is significant. 6 to 36 months follow-up, efficacy and stability. Conclusion Resection replantation of skin lesions plus the treatment of severe limb lymphedema and effective. Chinese papers League finishing.
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