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Groin Flap for Reconstruction of Traumatic Degloving Hand Injury: A Report of 5 Cases. 腹股沟皮瓣重建外伤性手部脱手套损伤5例报告。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.1.63
Jose De Jesus Orozco-Grados, Jorge Carrillo Cordova, Jose Antonio Garcia Garcia, Dania Y Baez Armenta, Abraham Arroyo Gonzalez, Daniel Chacon Galvis

Degloving is a type of avulsion injury that leads to the separation of the skin from its underlying tissues. It is usually caused by industrial machinery through smashing or traction mechanisms, where the patient typically tries to avoid severe trauma by pulling their hand off, resulting in this particular injury. Although free flaps have now become the standard of treatment in many institutions, the lack of this possibility makes pedicled flaps a good reconstructive option, with advantages such as low donor-site morbidity, low procedure costs, and relatively easy dissection of the flap. Since the description of the pedicled groin flap technique by McGregor and Jackson, this reconstructive option has become a versatile flap for the coverage of wounds on the hand and distal forearm. This axial-patterned cutaneous flap is based on the superficial circumflex arteriovenous system, which can provide soft-tissue coverage for moderate-to-severe injuries, especially those caused by work accidents. This article aims to describe our experience in treating five different cases of traumatic degloving hand injuries using a groin flap for coverage, with excellent aesthetic and functional results. Two of these cases resulted from degloving after a traction accident, one from a firework explosion, one from a gunshot, and finally, one as a result of an electric wound.

脱手套是一种撕脱伤,会导致皮肤与其底层组织分离。它通常是由工业机械通过粉碎或牵引机制引起的,在这种情况下,患者通常会通过将手拉开来避免严重的创伤,从而导致这种特殊的伤害。虽然自由皮瓣现在已成为许多机构的标准治疗方法,但缺乏这种可能性使得带蒂皮瓣成为一种很好的重建选择,其优点是供区发病率低,手术成本低,皮瓣剥离相对容易。自McGregor和Jackson描述带蒂腹股沟皮瓣技术以来,这种重建选择已成为覆盖手部和前臂远端伤口的多功能皮瓣。这种轴型皮瓣是基于浅表旋转动静脉系统,它可以提供软组织覆盖中度至重度损伤,特别是那些由工作事故引起的。本文旨在描述我们使用腹股沟皮瓣覆盖治疗5例不同的创伤性脱手套手部损伤的经验,具有良好的美学和功能效果。其中两个是牵引事故后脱手套造成的,一个是烟花爆炸造成的,一个是枪击造成的,最后一个是电伤。
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引用次数: 0
Successful Closure of an Oro-Antral Communication, after Three Previously Failed Attempts, Using Bichat Fat Pad Flap: A Case Report. 在三次失败尝试后,使用Bichat脂肪垫皮瓣成功关闭口-心房通信:一例报告。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.1.90
Despina Luciana Bereczki-Temistocle, Simona Gurzu, Ioan Ioan, Golu Mihai Vlad, Gabriela Beresescu, Alina Ormenisan

An oro-antral communication represents an abnormal connection between the oral cavity and the maxillary sinus. It occurs most often after tooth extractions, improper implant placement or incorrect management of the sinus lifts. Surgical repair is challenging and most practitioners usually choose the buccal advancement flap, the palatal flap and in some cases the buccal fat pad flap to close the defect. We present a 43 year-old female of a large oro-antral communication and associated chronic sinusitis which was succesfully manged by surgery. Previous interventions including 2 buccal advancement flaps, and a double layer closure using Collagen membrane and buccal advancement flap were unsuccesful. The stepwise intervention consisted on the complete cleaning of the sinus, using the Caldwell Luc technique, followed by the closure of the oro-antral communication using Bichat fat pad flap. The particular aspect was the proper integration of the buccal fat pad flap, after 3 failed attempts, without dehiscence or any other complications. The buccal fat pad flap can be succesfully used for closure of lage oro-antral communications, even when previous methods have failed and local tissue is of poor quality.

口-窦相通表示口腔和上颌窦之间的异常连接。它最常发生在拔牙、种植体放置不当或鼻窦提升处理不当之后。手术修复具有挑战性,大多数医生通常选择颊前瓣,腭瓣,在某些情况下,颊脂肪垫瓣来关闭缺损。我们提出了一个43岁的女性大口-窦交通和相关的慢性鼻窦炎是成功地通过手术管理。先前的干预包括2个颊推进瓣,以及使用胶原膜和颊推进瓣的双层闭合均未成功。渐进式干预包括使用Caldwell Luc技术完全清洁鼻窦,然后使用Bichat脂肪垫皮瓣关闭口-心房通信。特别的方面是颊脂肪垫皮瓣的适当整合,经过3次失败的尝试,没有开裂或任何其他并发症。即使以前的方法失败且局部组织质量差,颊脂肪垫皮瓣也可以成功地用于关闭大的口-窦交通。
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引用次数: 1
Comparison of the Outcomes of Surgical Repair of Cleft Palate Performed by Modified Von Langenbeck and Bardach (Two-Flap Palatoplasty) Methods. 采用改良冯-朗根贝克法和巴达赫法(两瓣腭成形术)进行腭裂手术修复的疗效比较。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.61186/wjps.12.3.94
Mehran Peyvasteh, Shahnam Askarpour, Negin Moradi, Adel Mansouri

Background: Cleft lip and cleft palate are one of the most common congenital craniofacial abnormalities in the skull and face. We aimed to investigate the prevalence of complications after primary cleft palate repair surgery, performed on patients referred to a children's hospital, and to use the information and results obtained from it to reduce the complications and improve the results of these surgeries.

Methods: In this cross-sectional-analytical study, using a census sampling method, the medical records of 94 consecutive cleft palate patients treated in Abuzar Hospital in Ahvaz, southern Iran, in the years 2019 to 2021 were studied. The rate of postoperative complications during the first week in terms of wound opening and flap necrosis and one month later in terms of fistula formation after surgery were also extracted from the files.

Results: Ninety-four patients with congenital cleft palate (57.4% male and 42.6% female) were enrolled. The gap width in all studied patients was 14 ± 5 mm. The frequency of complications of surgical wound opening, flap necrosis, oronasal fistula and hypernasality in von Langenbeck group was 9.5%, 0.15% and 28.1% respectively, and in Bardach group was 9.5 %, 15% and 33.3% respectively.

Conclusion: There were no significant differences between the two surgical methods in terms of postoperative complications. Besides, what is important in choosing a surgical method is the patient's clinical condition, the surgeon's experience and skill, and his choice.

背景:唇裂和腭裂是头颅和面部最常见的先天性颅面畸形之一。我们的目的是调查转诊到一家儿童医院的患者在接受腭裂修复手术后并发症的发生率,并利用从中获得的信息和结果来减少并发症,提高这些手术的效果:在这项横断面分析研究中,研究人员采用普查抽样方法,对伊朗南部阿瓦士市阿布扎尔医院在 2019 年至 2021 年期间连续收治的 94 名腭裂患者的病历进行了研究。此外,还从病历中提取了术后第一周伤口裂开和皮瓣坏死以及一个月后瘘管形成等术后并发症的发生率:共有94名先天性腭裂患者(57.4%为男性,42.6%为女性)接受了手术。所有患者的缝隙宽度为 14 ± 5 毫米。冯-朗根贝克组患者出现手术伤口裂开、皮瓣坏死、口鼻瘘和鼻孔过大等并发症的频率分别为9.5%、0.15%和28.1%,而巴达赫组患者出现这些并发症的频率分别为9.5%、15%和33.3%:两种手术方法在术后并发症方面没有明显差异。此外,在选择手术方法时,重要的是病人的临床情况、外科医生的经验和技术以及他的选择。
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引用次数: 0
What Is the Effect of Maxillary Impaction Orthognathic Surgery on Voice Characteristics? A Quasi-Experimental Study. 上颌咬合正颌手术对嗓音特征有何影响?一项准实验研究
IF 0.9 Pub Date : 2023-01-01 DOI: 10.61186/wjps.12.3.44
Hamide Ghaemi, Ricardo Grillo, Omid Alizadeh, Alireza Shirzadeh, Behnoush Ejtehadi, Masoud Torkzadeh, Sahand Samieirad

Background: Regarding the impact of orthognathic surgery on the airway and voice, this study was carried out to investigate the effects of maxillary impaction surgery on patients' voices through acoustic analysis and articulation assessment.

Methods: This quasi-experimental, before-and-after, double-blind study aimed at examining the effects of maxillary impaction surgery on the voice of orthognathic surgery patients. Before the surgery, a speech therapist conducted acoustic analysis, which included fundament frequency (F0), Jitter, Shimmer, and the harmonic-to-noise ratio (HNR), as well as first, second, and third formants (F1, F2, and F3). The patient's age, sex, degree of maxillary deformity, and impaction were documented in a checklist. Voice analysis was repeated during follow-up appointments at one and six months after the surgery in a blinded manner. The data were statistically analyzed using SPSS 23, and the significance level was set at 0.05.

Results: Twenty two patients (18 females, 4 males) were examined, with ages ranging from 18 to 40 years and an average age of 25.54 years. F2, F3, HNR, and Shimmer demonstrated a significant increase over the investigation period compared to the initial phase of the study (P <0.001 for each). Conversely, the Jitter variable exhibited a significant decrease during the follow-up assessments in comparison to the initial phase of the study (P< 0.001).

Conclusion: Following maxillary impaction surgery, improvements in voice quality were observed compared to the preoperative condition. However, further studies with larger samples are needed to confirm the relevancy.

背景:关于正颌外科手术对气道和嗓音的影响,本研究通过声学分析和发音评估,探讨上颌阻塞手术对患者嗓音的影响:本研究是一项准实验性、前后双盲研究,旨在探讨上颌阻塞手术对正颌手术患者嗓音的影响。手术前,语言治疗师进行了声学分析,包括基频(F0)、抖动(Jitter)、微光(Shimmer)、谐噪比(HNR)以及第一、第二和第三构音(F1、F2和F3)。患者的年龄、性别、上颌畸形程度和咬合情况都记录在检查表中。在术后 1 个月和 6 个月的随访中,以盲法重复进行语音分析。数据使用 SPSS 23 进行统计分析,显著性水平设定为 0.05:22名患者(18名女性,4名男性)接受了检查,年龄从18岁到40岁不等,平均年龄为25.54岁。与研究初始阶段相比,F2、F3、HNR 和 Shimmer 在调查期间均有显著增加(P 结论:上颌阻塞手术后,患者的上颌咀嚼功能明显改善:与术前相比,上颌阻塞手术后嗓音质量有所改善。不过,还需要对更多样本进行进一步研究,以确认其相关性。
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引用次数: 0
Lessons from Self-Assessment of Post-Rhinoplasty Complaints; Analysis of 192 Candidates of Secondary Rhinoplasty. 鼻整形术后投诉自我评估的经验教训192例二次鼻整形候选者分析。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.1.12
Shahriar Loghmani, Alireza Loghmani, Shirin Loghmani, Mohammadreza Zarei, Fatemeh Maraki

Background: Rhinoplasty as the most common aesthetic surgical operations aims to correct deformities of the different structures of the nose with each case its own challenges. We aimed to highlight the importance of self-assessment for rhino surgeons.

Methods: This retrospective descriptive study was done on 192 patients in Ordibehesht Hospital, Isfahan, Iran from April 2017 to Jun 2021. candidate for secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previously undergone rhinoplasty with the same or another surgeon. Patients with initial rhinoplasty by the first author were assigned to group 1 (n=102) and the patients who were operated by the other surgeons were in the group 2 (n=90). Data were collected using an author made checklist divided into three parts: overall demographic questions, questions about the patients' aesthetic and functional complaints and objective evaluation by the surgeon.

Results: The most frequent reported complaints led to their current rhinoplasty were about the nasal tip with 161 cases (83.9%), upper nasal part with 98 cases (51%) and mid-nose (middle nose) with 81 cases (42.2%). Besides, respiratory problem was observed in 58 patients (30.2%). Surgeon's skill was significantly associated with occurrence of these two complaints; so that these two complaints were more common in group2 than group1 (P value <0.05).

Conclusion: Such assessments resulted to improve the surgical outcomes due to finding the more prevalent problems in own patients than the other surgeons' patients and determining the reasons that leads to change the techniques with regard to the researches and consulting with the colleagues.

背景:鼻整形术作为最常见的美容外科手术,其目的是矫正鼻的不同结构的畸形,每种情况都有自己的挑战。我们的目的是强调自我评估对犀牛外科医生的重要性。方法:对2017年4月至2021年6月在伊朗伊斯法罕Ordibehesht医院就诊的192例患者进行回顾性描述性研究。曾在同一或其他外科医生处做过鼻整形手术的鼻整形候选人,具有强制性的美观性和可选的功能性目的。第一作者首次隆鼻的患者被分配到1组(n=102),由其他外科医生手术的患者被分配到2组(n=90)。使用作者制作的检查表收集数据,检查表分为三部分:总体人口学问题、患者审美和功能投诉问题以及外科医生的客观评价。结果:引起鼻整形的投诉以鼻尖部位161例(83.9%)、上鼻部98例(51%)、中鼻81例(42.2%)居多。此外,58例(30.2%)患者出现呼吸问题。外科医生的技术水平与这两种疾病的发生显著相关;结论:通过对本组患者的调查,发现本组患者比其他术者患者更普遍的问题,并通过与同事的研究和咨询,确定导致技术改变的原因,从而提高了手术效果。
{"title":"Lessons from Self-Assessment of Post-Rhinoplasty Complaints; Analysis of 192 Candidates of Secondary Rhinoplasty.","authors":"Shahriar Loghmani,&nbsp;Alireza Loghmani,&nbsp;Shirin Loghmani,&nbsp;Mohammadreza Zarei,&nbsp;Fatemeh Maraki","doi":"10.52547/wjps.12.1.12","DOIUrl":"https://doi.org/10.52547/wjps.12.1.12","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty as the most common aesthetic surgical operations aims to correct deformities of the different structures of the nose with each case its own challenges. We aimed to highlight the importance of self-assessment for rhino surgeons.</p><p><strong>Methods: </strong>This retrospective descriptive study was done on 192 patients in Ordibehesht Hospital, Isfahan, Iran from April 2017 to Jun 2021. candidate for secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previously undergone rhinoplasty with the same or another surgeon. Patients with initial rhinoplasty by the first author were assigned to group 1 (n=102) and the patients who were operated by the other surgeons were in the group 2 (n=90). Data were collected using an author made checklist divided into three parts: overall demographic questions, questions about the patients' aesthetic and functional complaints and objective evaluation by the surgeon.</p><p><strong>Results: </strong>The most frequent reported complaints led to their current rhinoplasty were about the nasal tip with 161 cases (83.9%), upper nasal part with 98 cases (51%) and mid-nose (middle nose) with 81 cases (42.2%). Besides, respiratory problem was observed in 58 patients (30.2%). Surgeon's skill was significantly associated with occurrence of these two complaints; so that these two complaints were more common in group2 than group1 (<i>P</i> value <0.05).</p><p><strong>Conclusion: </strong>Such assessments resulted to improve the surgical outcomes due to finding the more prevalent problems in own patients than the other surgeons' patients and determining the reasons that leads to change the techniques with regard to the researches and consulting with the colleagues.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/ba/wjps-12-12.PMC10200093.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9569486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation of Upper Extremity Trauma Registry: A Pilot Study. 上肢创伤登记的实施:一项试点研究。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.1.29
Yousef Shafaei Khanghah, Ali Foroutan, Alireza Sherafat, Mohammad Javad Fatemi, Hosein Bagheri Faradonbeh, Hossein Akbari

Background: Hand traumas are common in young men and their complications can have negative effects on their occupation and economic activities. On the other hand, most of the hand injuries are related to occupation accidents and thus necessitates preventive measures. The goal of a clinical registry is assisting epidemiologic surveys, quality improvement preventions.

Methods: This article explains the first phase of implementing a registry for upper extremity trauma. This phase includes recording of demographic data of patients. A questionnaire was designed. Contents include patients' characteristics, pattern of injury and past medical history in a minimal data set checklist. This questionnaire was filled in the emergency room by general practitioners. For 2 months the data were collected in paper based manner, then problems and obstacles were evaluated and corrected. During this period a web based software was designed. The registry was then ran for another 4 months using web based software.

Results: From 6.11.2019 to 5.3.2020, 1675 patients were recorded in the registry. Random check of recorded data suggests that accuracy of records was about 95.5%. Most of the missing data was related to associated injuries and job experience. Some mechanisms of injury seems to be related to Iran community and thus warrants special attention for preventive activities.

Conclusion: With a special registry personnel and supervision of plastic surgery faculties, an accurate record of data of upper extremity trauma is possible. The patterns of injury were remarkable and can be used for investigations and policy making for prevention.

背景:手部创伤在年轻男性中很常见,其并发症会对他们的职业和经济活动产生负面影响。另一方面,大多数手部伤害与职业事故有关,因此需要采取预防措施。临床登记的目标是协助流行病学调查,提高质量预防。方法:这篇文章解释了上肢创伤登记的第一阶段。这一阶段包括记录患者的人口统计数据。设计了问卷。内容包括病人的特点,损伤模式和过去的病史在一个最小的数据集核对表。这份问卷是由全科医生在急诊室填写的。在2个月的时间里,以纸质方式收集数据,然后评估和纠正问题和障碍。在此期间,设计了一个基于web的软件。然后使用基于网络的软件再运行4个月。结果:从2019年11月6日至2020年3月5日,注册中心记录了1675例患者。随机核对记录资料,记录准确率约为95.5%。大部分缺失的数据与相关伤害和工作经验有关。一些伤害机制似乎与伊朗社区有关,因此需要特别注意预防活动。结论:有专门的登记人员和整形外科医生的监督,可以准确地记录上肢外伤的数据。伤害模式显著,可用于调查和预防政策制定。
{"title":"Implementation of Upper Extremity Trauma Registry: A Pilot Study.","authors":"Yousef Shafaei Khanghah,&nbsp;Ali Foroutan,&nbsp;Alireza Sherafat,&nbsp;Mohammad Javad Fatemi,&nbsp;Hosein Bagheri Faradonbeh,&nbsp;Hossein Akbari","doi":"10.52547/wjps.12.1.29","DOIUrl":"https://doi.org/10.52547/wjps.12.1.29","url":null,"abstract":"<p><strong>Background: </strong>Hand traumas are common in young men and their complications can have negative effects on their occupation and economic activities. On the other hand, most of the hand injuries are related to occupation accidents and thus necessitates preventive measures. The goal of a clinical registry is assisting epidemiologic surveys, quality improvement preventions.</p><p><strong>Methods: </strong>This article explains the first phase of implementing a registry for upper extremity trauma. This phase includes recording of demographic data of patients. A questionnaire was designed. Contents include patients' characteristics, pattern of injury and past medical history in a minimal data set checklist. This questionnaire was filled in the emergency room by general practitioners. For 2 months the data were collected in paper based manner, then problems and obstacles were evaluated and corrected. During this period a web based software was designed. The registry was then ran for another 4 months using web based software.</p><p><strong>Results: </strong>From 6.11.2019 to 5.3.2020, 1675 patients were recorded in the registry. Random check of recorded data suggests that accuracy of records was about 95.5%. Most of the missing data was related to associated injuries and job experience. Some mechanisms of injury seems to be related to Iran community and thus warrants special attention for preventive activities.</p><p><strong>Conclusion: </strong>With a special registry personnel and supervision of plastic surgery faculties, an accurate record of data of upper extremity trauma is possible. The patterns of injury were remarkable and can be used for investigations and policy making for prevention.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/7a/wjps-12-29.PMC10200090.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Versatility of Local Fasciocutaneous Island Flaps for Resurfacing Soft Tissue Defects Overlying the Achilles Tendon. 局部筋膜岛状皮瓣修复跟腱软组织缺损的多功能性研究。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.1.20
Ahmed A Elhefnawy, Sherif A Hantash, Wael H Mahmoud, Wesam I Homouda, Mohamed M Khedr

Background: Reconstruction of soft tissue defects overlying the Achilles tendon has always been a challenge. Various modalities of reconstruction have been described to resurface such defects. We aimed to assess the functional and cosmetic outcomes of all patients who had undergone reconstruction of small and medium sized soft tissue defects of the Achilles region using local fasciocutaneous island flaps.

Methods: This retrospective study was conducted from January 2020 to June 2022. 15 patients with small (≤ 30 cm2) and medium (30-90 cm2) sized soft tissue defects of the tendo-Achilles region, underwent reconstruction with local fasciocutaneous island flaps and had complete medical records, were included.

Results: Thirteen patients were male (86.7%). The mean age was 53.2 years. 5 cases (33.3%) had post-traumatic open AT injuries with skin avulsion, while ten patients (66.7%) had suture line complications after open repair of spontaneous Achilles tendon rupture. Defect sizes ranged from 12 to 63 cm2. Reverse sural flap was used in 5 patients (33.3%) and medial plantar flap in 10 patients (66.7%). All flaps survived completely. Complications were detected in 3 patients (20%); 1 distal superficial necrosis in a sural flap and 2 marginal minimal graft loss. Functional outcome was good in 12 patients (80%), excellent in 1 patient (6.7%) and fair in 2 patients (13.3%). 13 patients (86.7%) were satisfied with the cosmetic results.

Conclusion: Local fasciocutenous island flaps are reliable and simple solutions for covering small to moderate soft tissue defects overlying the Achilles Tendon, with acceptable functional and cosmetic outcomes.

背景:跟腱上软组织缺损的重建一直是一个挑战。已经描述了各种重建方式来重新表面这些缺陷。我们的目的是评估所有使用局部筋膜皮肤岛状皮瓣重建跟腱区中小型软组织缺损的患者的功能和美容结果。方法:本研究于2020年1月至2022年6月进行回顾性研究。本研究纳入15例小(≤30 cm2)和中(30-90 cm2)腱-跟腱区软组织缺损患者,采用局部筋膜皮肤岛状皮瓣重建,并有完整的医疗记录。结果:男性13例,占86.7%。平均年龄为53.2岁。开放性跟腱损伤合并皮肤撕脱5例(33.3%),自发性跟腱断裂开放性修复术后缝合线并发症10例(66.7%)。缺陷大小从12到63平方厘米不等。逆行腓肠皮瓣5例(33.3%),内侧足底皮瓣10例(66.7%)。所有皮瓣都完全存活。并发症3例(20%);1例腓肠皮瓣远端表面坏死,2例边缘微小移植物丢失。12例(80%)患者的功能预后良好,1例(6.7%)为优,2例(13.3%)为一般。13例患者(86.7%)对美容效果满意。结论:局部筋膜岛状皮瓣是修复跟腱上小到中度软组织缺损的简单可靠的方法,具有良好的功能和美观效果。
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引用次数: 0
Comparison the Range of Motion Following Early Versus Late Active Mobilization after Repairing Surgery on Flexor Tendon Injury in the Zone II: A Randomized Clinical Trial. 比较 II 区屈肌肌腱损伤修复手术后早期主动活动与晚期主动活动的活动范围:一项随机临床试验。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.2.29
Hosseinali Abdolrazaghi, Mohammad Ramin, Hojjat Molaei

Background: Early or delayed mobilization of limb after flexor tendon rupture repairing has an effect on postoperative outcomes, however it is not yet clear whether early or late organ mobilization leads to more likelihood of recovery. We aimed to assess the effects of early and late active limb mobilization through rehabilitation after surgery on the range of motion and hand recovery.

Methods: This randomized clinical study was performed in Sina Hospital, Tehran, Iran in 2022 on 80 patients with flexor tendon damage in the zone II, who underwent reconstructive surgery of superficial and deep tendons. Patients were randomly (using random number table) divided into two groups that for one group, rehabilitation was done early (starting after three days, n = 53) and for the other group, rehabilitation was done late (starting after three weeks, n = 27). The patients were examined postoperatively and following occupational therapy and the range of motion of their involved joints was calculated.

Results: The means PIP extension Lag, PIP active flexion, DIP extension Lag, DIP active flexion and total active motion were all significantly higher in those patients planned for early mobilization as compared to those who considered for late mobilization(P=0.031). Such a significant difference was also revealed adjusting baseline parameters.

Conclusion: Compared to the delayed start of hand flexor tendon mobility, the early start of these activities is associated with a much greater improvement in the movement function of this tendon.

背景:屈肌腱断裂修复术后肢体的早期或延迟活动对术后结果有影响,但目前尚不清楚早期或晚期的器官活动更有可能导致康复。我们旨在评估术后通过康复早期和晚期积极活动肢体对活动范围和手部恢复的影响:这项随机临床研究于 2022 年在伊朗德黑兰的 Sina 医院进行,对象是 80 名在 II 区接受浅层和深层肌腱重建手术的屈肌腱损伤患者。患者被随机(使用随机数字表)分为两组,一组早期康复(三天后开始,53 人),另一组晚期康复(三周后开始,27 人)。对患者进行术后检查和职业治疗,并计算其受累关节的活动范围:结果:与考虑晚期活动的患者相比,计划早期活动的患者的PIP伸展滞后、PIP主动屈曲、DIP伸展滞后、DIP主动屈曲和总主动活动的平均值都明显更高(P=0.031)。结论:与延迟开始手部屈伸运动相比,延迟开始手部屈伸运动的患者手部主动屈伸和总主动运动量均明显增加(P=0.031):结论:与延迟开始手部屈肌腱活动相比,尽早开始这些活动与该肌腱运动功能的改善有很大关系。
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引用次数: 0
Autologous Platelet-Rich Plasma Injection and Platelet-Rich Fibrin Glue Insertion for the Treatment of Extensive Supralevator Anorectal Fistula: A Case Report. 自体富血小板血浆注射加富血小板纤维蛋白胶插入治疗广泛肛直肠上提瘘1例。
IF 0.9 Pub Date : 2023-01-01 DOI: 10.52547/wjps.12.1.58
Amin Dalili, Daryoush Hamidi Alamdari, Alimohamad Dalili, Maryam Sarkardeh, Alireza Rezapanah, Nooshin Tafazoli

Supralevator fistula stays a challenge in general surgery. We present a case with supralevator anorectal fistula and subsequent retroperitoneal necrotizing fasciitis in which autologous platelet-rich plasma and platelet-rich fibrin glue were used for fistula closure. A 59-year-old man was admitted with pelvic pain and fever. Abdominopelvic sonography and CT scan reported a deep horseshoe-shaped anorectal abscess with extension to the pelvic floor, supralevator, psoas, retroperitoneal muscles, and kidneys. He was managed with antibiotics, abscess drainage, repeated radical surgical debridement, and necrosectomy. After 30 days, he was discharged, but he returned to the office with the complaint of purulent discharge from the hypogastric region and a diagnosis of fistula formation. Platelet-rich plasma was injected around the fistula into the tissue, and platelet-rich fibrin glue was introduced to the fistula tract. At the 11-month follow-up, the patient did not have voiding dysfunction, constipation, diarrhea, or fistula tract infection. Autologous platelet-rich plasma injection and platelet-rich fibrin glue insertion suggest a secure and effective approach for treating supralevator anorectal fistula.

提上睑瘘是普外科的一个难题。我们报告一例肛直肠上瘘和腹膜后坏死性筋膜炎,其中自体富血小板血浆和富血小板纤维蛋白胶用于瘘闭合。一名59岁男性因骨盆疼痛和发热入院。腹部盆腔超声和CT扫描报告深马蹄形肛门直肠脓肿,并延伸至盆底、提上肌、腰肌、腹膜后肌肉和肾脏。他接受抗生素治疗,脓肿引流,反复根治性手术清创和坏死切除术。30天后,他出院了,但他回到办公室抱怨从胃下区域脓性分泌物和诊断瘘管形成。将富血小板血浆注入瘘管周围组织,将富血小板纤维蛋白胶注入瘘管道。在11个月的随访中,患者未出现排尿功能障碍、便秘、腹泻或瘘管道感染。自体富血小板血浆注射和富血小板纤维蛋白胶插入是治疗提上肛直肠瘘的一种安全有效的方法。
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引用次数: 0
Assessment of Maxillary Sinus Variations Post-LeFort: A Systematic Review. 评估下颌窦的变化:系统回顾
IF 0.9 Pub Date : 2023-01-01 DOI: 10.61186/wjps.12.3.3
Majid Eshghpour, Touraj Vaezi, Sahand Samieirad, Ali Manafi, Alireza Ebrahimpour, Abdolrahim Shams

Background: The purpose of this article was to systematically review maxillary sinus changes after LeFort. We examined and analyzed the anatomical abnormalities that occurred following LeFort I osteotomy, as well as the abnormalities of maxillary sinus volume (MSV) before and after the operation.

Methods: A systematic search was conducted on various databases, such as Google Scholar, PubMed, and Scopus. The articles used were in English and original. This study was conducted until September 2023, and after reviewing the articles, several keywords, such as "Maxillary sinus" and "LeFort I osteotomy", were employed. The obtained data were evaluated based on the PICO framework.

Results: Findings from 15 studies showed that the amount of MSV decreased before and after the operation (considering the three dimensions of the sinus, the measurement was performed linearly). These reduction values differed between men and women, with men having a greater reduction. As is the case with other operations, there were some side effects associated with this type of operation that some patients experienced postoperatively.

Conclusion: In both male and female patients, the MSV was reduced after one-piece and multi-segment osteotomies. Nonetheless, one-piece LeFort I osteotomy showed a higher reduction in MSV than the multi-segment osteotomy method, according to this systematic review and meta-analysis.

背景:本文旨在系统回顾LeFort术后上颌窦的变化。我们研究并分析了 LeFort I 截骨术后出现的解剖异常,以及手术前后上颌窦容积(MSV)的异常:在 Google Scholar、PubMed 和 Scopus 等多个数据库中进行了系统检索。所用文章均为英文原文。这项研究一直持续到 2023 年 9 月,在对文章进行审查后,使用了几个关键词,如 "上颌窦 "和 "LeFort I 截骨术"。根据 PICO 框架对获得的数据进行了评估:结果:15 项研究结果表明,手术前后 MSV 量均有所减少(考虑到上颌窦的三个维度,测量方法为线性测量)。男性和女性的减少值不同,男性减少得更多。与其他手术一样,这种手术也会产生一些副作用,一些患者在术后会出现这些副作用:结论:无论是男性还是女性患者,经过一片式截骨术还是多节段截骨术后,MSV 都有所降低。尽管如此,根据本系统综述和荟萃分析,一片式 LeFort I 截骨术比多节段截骨术能减少更多的 MSV。
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World Journal of Plastic Surgery
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