RESUMEN
The new local flap technique based on cutting out valve flaps combining with the principle of acute dermatension is presented in this article. The method is offered as alternative to plasty with transposed triangular flaps or Z-plasty and it allows to excise pathological scars, provides good esthetic results. On the basis of this technique some methods of eliminating post burn deformities of face, neck, mammary glands, extremities joints, hand and fingers are offered.
Asunto(s)
Quemaduras/cirugía , Cicatriz/cirugía , Contractura/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , HumanosRESUMEN
The article presents two methods of formation of the axilla cupola with saved skin from the area of hair growth, and when there are scarry changes. The first method allows exclusion of displacement of the axilla skin into not proper places. The second method gives better engraftment and better outcomes of operation. A method of two-stage treatment was worked out for severe contractures of the shoulder joint in order to avoid a transection of the tendons and muscles and overdistention of the vascular-nervous bundles. During the preoperative period a gradual liberation of the shoulder is to be fulfilled by means of a dosated distraction of the scars, contracted tendons and muscles. The dosated distraction is performed using a specially developed splint with a turnbuckle mechanism. Using the splint the full volume of movements was restored in 73.9% of the patients. In the rest of the cases operative treatment was used, and the distracted scarry tissues can be used as plasty material.
Asunto(s)
Quemaduras/complicaciones , Quemaduras/cirugía , Cicatriz/etiología , Cicatriz/cirugía , Contractura/etiología , Contractura/cirugía , Procedimientos de Cirugía Plástica/métodos , Articulación del Hombro/cirugía , Contractura/fisiopatología , Humanos , Articulación del Hombro/fisiopatologíaRESUMEN
Results of surgical treatment of 479 patients with deep burns of the upper extremities on the area from 0.5 to 60% of body surface with the lesion of shoulder (398), elbow (407), radiocarpal (371) joints and hand (423) area. Early or delayed necrectomy (28.6%) with following skin grafting was performed at hospitalization of patients in early period. At IV-degree burns plastic reconstruction with skin-subcutaneous flaps was used: local (22), combined (16), pedicle flap and Filatov's graft (29), flaps with axial circulation (8) and on microsurgical anastomoses. Active surgical policy resulted in recovery of the function of the shoulder joints in 73.7%, elbow joints--in 75.15%, radiocarpal joints--in 83.4% and of hand in 50.2% cases.
Asunto(s)
Quemaduras/rehabilitación , Traumatismos de la Mano/rehabilitación , Procedimientos de Cirugía Plástica/métodos , Cicatrización de Heridas/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Quemaduras/patología , Quemaduras/cirugía , Estudios de Seguimiento , Traumatismos de la Mano/patología , Traumatismos de la Mano/cirugía , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Trasplante de Piel , Colgajos Quirúrgicos/irrigación sanguínea , Índices de Gravedad del TraumaAsunto(s)
Cicatriz/cirugía , Contractura/cirugía , Cuello/cirugía , Trasplante de Piel/métodos , HumanosAsunto(s)
Quemaduras/complicaciones , Contractura/terapia , Traumatismos de los Dedos/terapia , Deformidades Adquiridas de la Mano/terapia , Traumatismos de la Mano/complicaciones , Luxaciones Articulares/terapia , Tracción/métodos , Contractura/etiología , Diseño de Equipo , Traumatismos de los Dedos/etiología , Deformidades Adquiridas de la Mano/etiología , Humanos , Luxaciones Articulares/etiología , Tracción/instrumentación , U.R.S.S.Asunto(s)
Contractura/prevención & control , Traumatismos de los Dedos/complicaciones , Deformidades Adquiridas de la Mano/prevención & control , Complicaciones Posoperatorias/prevención & control , Trasplante de Piel/métodos , Contractura/etiología , Contractura/cirugía , Traumatismos de los Dedos/cirugía , Deformidades Adquiridas de la Mano/etiología , Deformidades Adquiridas de la Mano/cirugía , Humanos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Recurrencia , Tracción/instrumentaciónRESUMEN
The author proposes an original method for reconstruction of the Filatov pedicle after its partial necrosis at the expense of cutting an additional flap and suturing it with the greater remnant of the healthy primary Filatov pedicle.
Asunto(s)
Músculos Abdominales/cirugía , Músculos/trasplante , Trasplante de Piel , Colgajos Quirúrgicos , Humanos , Músculos/patología , Necrosis , Complicaciones Posoperatorias , Reoperación , Piel/patologíaRESUMEN
The authors propose methods for closing vast defects by cutaneous-fascial grafts transferred on the Filatov's pedicle through the upper extremity. These whole thickness grafts must be previously subjected to surgical training which eliminates risk of ischemia. The tubular feeding pedicle is convenient for care and prevents infections in the postoperative period. The first method consists in the forming of the Filatov's pedicle (as the first step) which is then transferred onto the hand (the second step). In the first method both steps are supposed to be fulfilled simultaneously in order to shorten time of treatment. The methods described were used for closing great wounds on the head and lower extremities in 8 patients.
Asunto(s)
Traumatismos de la Pierna/cirugía , Cuero Cabelludo/lesiones , Colgajos Quirúrgicos , Humanos , MasculinoRESUMEN
Under study was the reestablishment of the pain, tactile and thermal sensitivity in free skin grafts in 265 patients in the period from 2-3 weeks till 25 years after free skin plasty for burn sequellae. The pain sensitivity was found to appear by the end of the first month. The tactile sensitivity was reestablished not earlier than within 1,5 month. The first signs of the thermal sensitivity made their appearance within the terms of from 3 to 6 months. By the end of the year the reestablishment of sensitivity was not accomplished.