Communication between the bladder prostate cerclag

e707004304 · Wysłany: Nie 23:35, 06 Mar 2011

Communication between the bladder prostate cerclage hemostasis in suprapubic prostatectomy Application

Bedsores 5 down. Sores disappear after Pi. If satisfied with the surgical teaching. Are as follows. 1 General Information 5 clinical data pour in 1.1. 3 males. 2 females. Age 25 to 36 years old. Average 29.4 years old. 5 cases of ulcer formation are people outside the hospital Nou hospital. Cause: car accident caused by thoracic spine fracture in 3 cases of complete paralysis, cerebral coma in 1 case, 1 thoracic junction edges down with paralysis. Bedsores Level: 5 cases of grade Ⅳ Nou sacral sores are bed sores, the scope Sheng Tai l0cm × 9cm, minimum 8cm × 8cm. With various degree of infection and necrosis of the sacrum. 1.2 surgical patients prone position. No anesthesia, cleaning and scraping the surface after planing bedsores packing with sterile gauze closed. Muscle flap to the left posterior superior iliac spine and greater trochanter tip of the axis of the connection lines for the muscle flap. Piriformis superior gluteal artery to the upper edge of shallow point of spending that flap in the axis line 1 / 3 of the intersection as a muscle flap rotation point to the point to increase pressure sore on the right margin of 1.5cm from the draw Department of muscle flap in the greater trochanter of the most connected points, the farthest point to flap up and down with the hoe sores flared end for connection to a remote the size of the muscle flap rotated to cover the Nou sore bone design planing surface {grumble Cut the top flap. Gluteus maximus and hip along with your fingers loose connective tissue in the muscle separated from flap rotation point can be seen piercing the superficial branch of superior gluteal artery gluteal muscles and piriformis and entered into the upper part of the gluteus maximus,[link widoczny dla zalogowanych], separation of the blood vessels Cambodia after the use of film protection. Then cut the bottom for the flap [1 through split gluteus maximus muscle, the gluteus maximus to free the upper part, the formation of superficial branch of superior gluteal artery as a vascular pedicled island flap. Bedsore at the resection margin of 0.5cm along the entire bed sore,[link widoczny dla zalogowanych], sacral bony protrusion after the sudden and infected with the removal of cortical bone, bleeding profile. 180 down the flap. Distal muscle flap after coverage with the wound bed sores, muscle and skin closure by muscle flaps of the greater trochanter after planing surface defects with big eyelashes with free skin graft to cover the 1.3 results of muscle flap down after 5 flaps survived, hoe sores disappear. 2 cases of skin flap flap infection healed after dressing change. 2 to discuss the characteristics of flap 2.1 Marava-Ilta 1980 was the first reported to the superior gluteal vascular pedicled island gluteus maximus muscle flap Nou sacral sore ... from the superior gluteal artery after internal iliac artery dried, the upper edge into the hip piriformis were divided into two shades. One superficial branch of the piriformis and gluteal muscles after piercing the gap in several fan-shaped distribution of support to the upper half of the gluteus maximus. Superficial branch of superior gluteal artery with a relatively constant anatomical parts, blood vessels into the gluteus maximus in front of a certain length to facilitate rotation, the caliber of blood vessels have some adequate blood supply and so on. Therefore, superficial branch of the superior gluteal artery for the vascular pedicle of the gluteus maximus muscle flap with the upper part of a larger area for the organization to take. Rotation amplitude,[link widoczny dla zalogowanych], rich blood supply,[link widoczny dla zalogowanych], anti-infective ability, muscle pad wear characteristics for the village. During surgery we cut the maximum area of flap 17cm × 12cm. The formation of distant flap rotation is still full of bleeding, its large enough to effectively cover the Nou experience treating sore wounds grade Ⅳ 2.2 bedsore larger, tend to form local ulceration and necrosis,[link widoczny dla zalogowanych], dressing difficult to heal. To be repeated several times before surgery to remove necrotic tissue expansion plane, bow completely abortive. Infection control, enhance the body nutrition. Surgery Note: (1) surgical procedures carried out according to strict anatomical level, reduce the amount of bleeding; (2) before the formation of the flap should not rush to remove pressure ulcers. Plane in case of surgical failure to prevent bedsores surface can not be repaired; (3) near the free muscle flap rotation to take some time vascularized loose connective tissue; (4) muscle flap should be large enough. Ning not small, Ningsong not tight; (5) pressure sores should be the bottom of the follicles Shuhei. Expand the weight-bearing bone area and make it smooth; (6) muscle flap transposition to avoid pressure; (7) for the District planing surface can not draw close, need free skin graft repair; ( Cool

should be placed after flap adequate drainage. 2.3 The impact of postoperative upper gluteus maximus gluteus maximus island flap of the lower part of the reservation, had little effect on the extension of hip function. It has been reported 4 years after non-paralytic review for the lower half of the gluteus maximus area still retains a good stretch of hip function, gait normal】. Flap after the appearance of the buttocks changed greatly uplifted by the valve area, valve area for depression. 5 patients in this group were paraplegic or unconscious patients. The possibility of recovery is small, it is not made on the appearance and function of 3 more stringent requirements