As soon as Pi Ban has the subcutaneous fat organization which the blood supply’s skin and adheres to stick cohere to form. In the skin petal forms with the transition process, must have part and the main body (for Pi Banqu) connected, this connected part is called the peduncle department, maintains the blood supply, other separate in the surface and the deep surface with the main body, shifts after another injured area (Pi Banqu), still by the peduncle department blood circulation supply nutrition, and so on injured area blood vessel long entered temporarily Pi Banqu the skin petal, after establishing the new blood circulation atomic, the peduncle department cut-off, the beginning completes again the skin petal shift the entire process, therefore other name belt Tippy petal, but after partial Pi Banhuo island shape skin petal shift,Does not need to break the peduncle.
Skin petal transplant operation indication:
Because skin petal oneself has the blood supply, simultaneously also has the subcutaneous fat to treat the merit, therefore its use on is also different with the dissociation skin piece lorus, mainly uses in the following several aspects:
(1) repair has the tendon, the bone, the joint, the trunk, the nerve to wait the organization exposed fresh injured area or the obsolete wound.
To has the depth portion to organize the injured area which (tendon, trunk, nerve) the damage or appears externally, the unstable scar clings the bone surface or the merge has ulcer’s scar, to strengthen the partial soft tissue’s thickness, or carries on organization’s and so on tendon, nerve, bone, joint for the later period repairs, should execute the skin petal repair.
(2) organ restoration
Like nose, lip, eyelid, eyebrow, ear, penis, finger’s restoration all by Pi Banwei the foundation, coordinates other support organization again (for example cartilage, bone, fascia and so on) transplant.
(3) pierces the damage repair
If the cheek department pierces the damage, besides manufactures the lining also often to need to have rich blood circulation Pi Ban to cover. In addition the bridge of the nose, on the palate and so on place pierces the damage, the vagina visical fistula or the rectal fistula repair must defer to pierces the damage principle of reatment execution surgery, organizes two parts including the lining organization and the cover.
(4) enhancement partial blood circulation
Improvement nutrition condition like radioactive ulcer, the bedsore and so on, the partial nutrition is deficient, the wound is very difficult to heal, through skin petal transportation blood, improvement partial nutrition condition, thus this seed shell petal should better be partial axis Pi Banhuo the island shape skin petal, and cannot do breaks the peduncle surgery dress, like this not only may maintain the repair area the good blood supplies, and hopes to have the good feeling restoration.
Skin petal transplant operation way:
(1) damage judgment: First clarifies the damage place state, including
①Spot 1920s,
②Shape,
③Size,
④Whether there is serious luan to shrink the situation,
⑤Periphery skin condition,
⑥Creates the base condition and so on, and aims at the above situation choice suitably for Pi Banqu, if before the neck, and joint spot if has luan shrinks, after the scar loose solution’s damage area will grow possibly several, must estimate fully, this time the available healthy side or the healthy persons same spot does on a small scale the forecast greatly. Reduces in the design the error.
(2) supplies Pi Banqu and the skin petal type choice:
The choice principle has the following several points approximately:
1. the choice skin quality of material, the color approximate spot to supply Pi Banqu’
2. by partial, neighbor skin petal, the safe simple plan is a first choice’
3. should avoid nonessential “the detention” as far as possible and the indirect shift’
4. Pi Ban designs the area size, should compared to after passing through the excision scar loose solution the actual injured area also want about big 20%’
5. should as far as possible select blood circulation rich axis Pi Banhuo the island shape skin petal transplant.
(3) goes against the flow the design:
Goes against the flow the design or “the tailor test specimen” is Pi Ban designs the essential step, its approximate procedure is as follows:
1. first for Pi Banqu to draw the damage area to need the skin petal size, the shape and peduncle’s length’
2. uses the paper (or cloth) Pi Ban who cuts the simulation according to the above graph’
3. again peduncle department fixed Yu Gongpi the petal area, (or cloth) raises the papier-mache, the implementation to shift one time, regards it whether can quite loose the damage area cover, so on hospital bed the body posture which and may endure according to patient’s actual situation, the simulation competition’s design method calls to go against the flow the design, also calls the skin petal reversal design law, it is prevents the design to be separated from the actual situation effective measure, discusses when the surgery is noticeable and the abbreviation, because only then through this kind Pi Ban who goes against the flow the design to be able to examine us to design, its concrete size, the position, whether do the shape tally with the damage area, whether does the patient endure to this kind of body posture.
(4) Pi Ban formation:
The skin petal forms when should pay attention to Pi Ban the blood circulation, after the skin petal forms, the early nutrition supply mainly depends upon the peduncle department blood circulation supply, maintains its vigor. Random Pi Banchang and the wide proportion are not generally suitable surpass 2:1, in surface pate, because the blood circulation is good, the length and breadth proportion may increase slightly 2.5~3:1, surpasses certain proportion skin petal far-end then to present the blood circulation barrier or necrosis, designs Pi Banshi should also cause the peduncle department slightly to extend carry, and circulates the main blood vessel to walk the good direction, guarantees the blood circulation. Gradually was in recent years thorough to skin’s blood vessel structural research, drew up the skin artery a schema chart might supply to form Pi Banshi grasps the level the reference.
Pi Ban the artery supply is no doubt important, but its venous return is also noticeable, if the venous return is not good time, then Pi Ban swelling or the blister and becomes the dull purple, because finally organizes the swelling oppression artery seriously, causes the blood stream to block completely, skin petal necrosis. Nourishes Pi Ban the main blood vessel in the skin petal in-depth organization, when large-scale skin petal separation must include the deep fascia, protects in the subcutaneous fat deep surface network of bloodvessels.
If felt after Pi Bantai affects the repair when thick partial function or appearance, may after the skin petal shift survives 3~ June, again at different times fat excision (i.e. degreasing technique).