Possibilities of application of composite bone-soft tissue complex in reconstructive surgery.
Hereby the method of formation of bone-soft tissue complex with its future application in reconstructive surgery is presented. Treatment of spacious defects of human body with soft tissue lost as well as with bone injury is considered as critical problem in contemporary surgery. Even today, there is no final reference regarding the particular sort of flat to be applied in each specific case. Method of formation and flap taking is one of the most complicated and crucial stages of the operation. Operation of free transplantation of compound composite flaps of soft tissues, muscles and bones, including microvascular anastomosis, was done for 66 patients; in total 68 transplantations were carried out. the patients were provided with clinic-laboratory analysis; identification of deficient tissues, X-ray, dopplerography, determination of various sorts of sensitivity, biomechanical examinations and tests, and bacteriological tests. 66 patients with grave injuries of bones and soft tissues were operated. In 86,8% of total good functional and esthetical effect was reached, and in 11,8%--the outcomes were estimated as satisfactory. While observance of all technical rules for flap formation precision during formation of vascular pedicle, accurate selections of form and flap dimension are of significant importance. During solution of this very problem, auto-transplantation of tissue flaps is deemed to be highly effective method of treatment. It is worthy to note, that value of micro-surgical transplantation, such as lack of lingering immobilization of extremities, is of crucial importance for children and adolescent as far as it prevents development of hard mobility of joints and saves from obligatory lingering confinement to bed during treatment with traditional methods (Italian plastics, Phylatov's stalk, etc.) The offered method of formation of bone-soft tissue complex facilitates technical sides of transplantation and monitoring. In case of serious bone-soft tissue defects, transplantation of rib-thoracodorsial complex is considered as method of choice.
Peradze
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National Center of Surgery, Tbilisi, Georgia.
Peradze
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D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001842:Bone and Bones; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery; D014947:Wounds and Injuries / Q000601:surgery / Q000628:therapy*
D001672:Biocompatible Materials