Free tissue flap transplantation in clinical application in.docVIP

 PAGE \* MERGEFORMAT 6 Free tissue flap transplantation in clinical application in [Keywords:] Magnetic resonance angiography MRA (magnetic resonance angiography, MRA has been widely used in the brain, neck, heart, kidney and lung clinical diagnosis and treatment, but its clinical application in hand surgery is rarely reported. Since February 2004 in the free flap of transplantation, the use of donor, recipient of the MRA line preoperative planning, intraoperative guidance, and postoperative monitoring, and achieved good results. 1 Clinical data 1.1 General Information The group of 22 patients, 18 males and 4 females, average 41 years old (12 to 63 years, type of tissue flap: A flap in 5 cases, re-toe transplantation in 4 cases, 6 cases of anterolateral thigh flap, dorsalis pedis flap 3 cases, 2 cases of toe web flap, fibular graft in 2 cases. 1.2 Methods NOVUS 1.5T MRI using Siemens, using 2D-TOF or 3D-TOF method, if necessary, with CE-MRA method for Region two and three dimensional imaging, 8 cases by the District of severe tissue injury to the affected area while MRA imaging. According to defects in the size, shape, defect type, and the performance of donor preoperative MRA design (Figure 1 and 2, including the flap size, shape, direction, organization structure, combined with arterial pulse points, or bone and other anatomical point of conflict position for the division in the edge of the flap, mark the vein of the flap blood supply to the branch and its sub-type. The difficulty is greater if the first metatarsal foot dorsal artery Gilbert Ⅲ type can choose contralateral foot as the donor . Reference at any time during the operation two, three-dimensional imaging of the MRA, intuitive understanding from all angles vascularized flap direction, branches, distribution and other characteristics, to avoid accidental injury may reduce the trauma for the area, the combination of MRA and anatomical images, can better match to choose blood