PHCN vdi thang d i l m Lysholm sau p h i u thudt p <
0,05 (Bang 4).
KfeT LUAN
Kit qua tpo hinh DCCT ky thudt hai bd bang gdn Hamstring eua 39 bpnh nhan tai Benh vien Viet Ddc t d 2011 - 2012 kha kha quan vdi d i l m Lysholm tmng binh 90.33. ty Ip tdt va i^t tot Id 94,6%, nghiem phdp ngdn kPo tnrdc va Laehman (-) 92.3%, Pivot - shift (-) 96.4% trudng hap.
Trang nghiPn euu cd nhieu y l u t l anh huang den kit qua theo ffilm Lysholm nhung t i n thuang kem ttieo vd tdp PHCN Id hai y l u to anh hudng ro nPt.
TAI LI^U THAM K H A O
1. Daniel Hensler M.C.F.V.E MD. PhD .Freddie H.
Fu MD, DSc DPs. James J, In-gang PT PhD (2012).
Anatomie Anterior Cruciate Ligament Reconstruction Utilizing the Double - Bundle Technique. Joumal of orthopaedic sportsphysicaltherapy, A2, 184-195.
2. John Nyland. Charles Crawford, Sarah Landes, Richard Jackson, hlaw Chong Chang, Akbar Nawab, David N, M. Cabom (2007). Anatomic double bundle ACL reconstruction: a literature review. Knee Surg Sports Tmumatol Arthmse, 15. 946 - 964.
3. Jonsson H, Riklund - AhlstrOm K, and Lind J (2004). Positive pivot shift after ACL reconstruction predicts later osteoarthrosis 63 paitents followed 5 - 9 years after surgery. Acta Orthopaedic. 75(5), 594 - 599
4. Ferretti A et ai (1991). Osteoarthitis of the knee
after ACL reconstruction. Intel national orthopaedic, 15(4). 367-371.
5. Lohmander L et al (2004). High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior enjciate ligament injury. Arthritis & Rheumatism. 50(10).
3145-3152.
6. Biau D.J^t ai (2007). ACL reconstruction: a meta- analysis of functional scores Clinical Orthopaedics and Related Reseamh. 480, 180 -187.
7. Matsushita R.KT (2011). Anatomic double bundle anterior emeial ligament reconstmction with G - ST. Cum Rev Musculoskelet Med, 4, 57 - 64.
8. Pham Ngoc Trudng (2013) Dinh gia kit qua ndi soi dieu tri ton thwong dut day chang cheo trwdc bing ky thuit hai bo bin dudng him. Lupn vdn Thpc sy Y hpc, Hpc vipn Qudn y.
9. Tran Hoing Tung. Ngd Van Toin (2013). Nghien ciru Ong dung ngi soi dieu tri dwt DCCT khdp gdi bang manh ghep gin ddng loai tai Bdnh vidn Vidt Due Hi Ngi Tap chi Chin thuong chinh hinh Vipt Nam, Hpi nghj khoa hoe thudng niPn lan XII, S6 dac bipt Quang Ninh 2013.
lO.Oberoi IPS. MS (Ortho). Vivek Jain. MS (Ortho), Kuldeep Singh Nahawat, MS (Ortho) (2010). Anatomical double bundle ACL reconstmction using hamstring tendon graft - clinical evaluation. Joumal of Clinical Orthopaedics and Trauma. 1(1) 26 - 32
UNG DUNG NHANH TRAN DONG MACH THAI DUUNG NONG TRONG P H A U THUAT TAO HINH VUNG DAU - MAT
PHAM TH! VIET DUNG, TRAN THIET SON Bp mon Phiu thuit Tao hinh, Trwimg Dai hgc Y Hi Ngi T6M TAT
Nhdnh trdn li mdt trong hai nhinh tan cua dgng mach thdi duong ndng tdch ra tir trdn cung tiip gd md khodng 3cm. Di/a trdn nhinh ndy c6 thi liy dc V9f td chOc dOng trong phiu thuit (po hinh diu mit cd. Mgc dich cua bdi bdo nay md ti mdt sd Ong dung cOa vgt dwgc nudi nhinh trdn ddng mach thdi duong ndng trong tao hinh khuyit phin mim vung diu - m$f. Nghidn cOv niy dwgc tiin hdnh trdn 21 bdnh utiin cd tdn thuong khuyit phin mim vira vi nhd vdng diu - m$t. Kit qui cho thiy. tO- ddng mach nay c6 thi liy chit li$u li vat da diu mang tdc cho nhimg flin thwong khuyit nhd d da diu, khuyit cung may ttay ria mdp ho$c liy chit lieu id vgt da diu khdng mang t6c t^o hinh cho nhung khuyit phin mim vung quanh mit, thii duong. dnh m0i...V9t cd thi dwgc s * dijng dwdi dgng vat xudi ddng hay nguoc ddng.
Tmng sd 21 vgt cd 4 vgt bi ir tinh m^ch nhwng si/ tidi luu linh mgch trd l^i binh thwdng sau 1 tuin. Tit ci cdc vgt diu sdng toin bd vi dip ung dwgc ydu ciu t^o hinh d noi nhdn vgt
TCP khda: Nhdnh trin ddng m^ch thii dwang ndng. vat nhdnh trdn dgng mach thdi dwong ndng.
DAT V A N Dt
Nhung khuylt phan mem vCing d i u - mdt khd thudng gpp do nhilu nguyen nhan khde nhau nhu bdng, chan thuang, benh II hay dl tpt b I m slnh...Dl giai quyet ede t i n thuang ndy, p h i u thudt tao hinh cd r l t nhilu phuangphap t u dan gian nhu ghep da den nhlj-ng vat tai chd. vpt Idn can, vat gidn t l ehde hay cac vat t y do. Trong dP, phuang phdp dan gian nhit vd eo ket_qua tham ml kha quan nhit Id sd dung ede vat tai ehd vd Idn cdn do ed mdu sde vd tinh c h i t da tuang d i l tuang d i n g . Ngdy nay trPn t h i gidl dd c^
rat nhieu tde gia sd dyng vpt nhanh trdn ddng mach thdi duang ndng (hay cdn gpi Id vpt trdn ngang) cho nhung t i n khuylt viing nay. Uu t h i cua vat Id cP mdu sde dong deu vdi vOng da lan cpn d trdn - mat - eo. Tinh chat vpt mdng, mem mai, cuong mach nudi Idn vd mpng mach trong can IPn nudi da phong phii npn vat da cd sue sdng cao vd kT thupt bde vat khPng qud phde tpp.. Ngoai ra, vat nhdnh tran eP t h i l l y da d i u mang t i e trong tao hinh dan vi mi trdn vd Idng mdy hay ria mPp... Nai eho vpt ed t h i ddng true tiep hodc gliPp da. manh da ghPp trPn n i n cdn so duac nuPi dudng t i t , qud trinh lien v i t thuang thudn Ipi. d
Y H O C T H U C HANH fQdSl.QA i / i n i c
ViPt Nam. eung eo mpt s l ea sd s u dung vat nay cho p h i u thudt tao hinh vung d i u - mat nhung ehua cP nhilu ngliiPn ciru d l y dii v l ung dung ciia vat trong phdu thudt tao hinh Vi vay, nghien euu nay duac thye hipn vdi mye tieu: Ddnh gid k i t qua dng dyng vat_ nhdnh trdn dpng mach thai duang nPng trong phdu thudt tao hinh dau mat co.
D 6 | TU-pNG VA PHUANG P H A P NGHIEN CLPU NghiPn edu can thiep lam sdng:
T d thdng 1/2007 d i n thang 6/2014, tai Khoa Phdu thupt Tpo hinh, Bpnh vipn Xanh Pdn. 21 benh nhdn t u l i t u 4-64 cd khuylt phan m i m vua va nhd viing d i u , mdt dupe phdu thudt bang vat nhdnh tran dpng mpch tfidi duang ndng.
Quy trinh phdu thudt:
Chuin bi bpnh nhdn trudc mo: Benh nhdn duac khdm, ddnh gid t i n thuang de xde d|nh c h i t lieu can tao hinh, cao tPc viing mo, sieu dm tim dudng di eua
nhanhtran, trPn c a s d dd t h i l t k l vat.
Phau thupt dupe thyc hipn dudi gdy mP npi khi quan ho§c gay tP tpi ehd. Sau khi t i n thuong dup'c cat bo. Idm speh, t i l n hdnh p h i u tich vpt- Rpch da trdn dudng di ciia tnje mpch, tim dpng mpch, bde tdch mach eting 2-3em cdn xung quanh mpch dpe t u d i d di vdo vat cua dpng mpeh d i n ehP phdn chia nhdnh tan eda dpng mpeh thdi duang ndng. Trong mot s l tnj'Png hap e l n eulng mpch ddi, phdi bde tdch tdi tan ch6 ra khdi tuyin nude bpt mang tai eiia dpng mach thdi duang ndng. thdt bd nhdnh dtnh d l tang dp di dpng (^o nhdnh trdn. Rpeh da theo thilt ke. Bde vpt da edn sao eho dpng maeh di trong vat.
Sau kht vat dwqrc giai phPng hodn todn khdi nai eho, nd dupe dua d i n nai nhdn qua mpt dudng h i m dudi da n i l gida g l c ciia cudng mpch vdt nai b| t i n thuang. Vat dupe diing d l che phO hope dyng hinh ea quan bj ton thuang
Hinh 1; Quy trinh phiu thuat diuyln vgt nhSnh trdn ddng mach thii duang ndng A: Phdn tich tdn thuong. B: Siiu im mgch vi thiet ki dwa trdn dwdng d)' cOa mgch
C: Tim cudng mach. D: Chuyin vat din noi nhan vat; E: Ddng vgt vi nai cho vgt; F: Khim Ig,! sau m6 Sau m l , benh nhan duac khdm, theo ddi sau mo 1 t u l n , 1 thdng. 3 thdng.
K t T QUA Bdng: K i t qud lam sang Vjtrl
Trln-thli duang Mi trdn Mi dud'i Ou6i mIt CCing at Cinh mui Da diu
Cung mdy Ria mlp Tdngsd
Sdca 1 1 7 4 4 1 1 2 1
Nguyen nhin Dj tSt bIm sinh Chan thuang 3 b6ng/4 chan thuanq Chin thu-o'nq
Khoet nhan clu do K Chdn thuong Chan thuang Bdng/ dj tat
bIm sinh Bong
Dien tich (cm) 9x10 1 5x2.8 1 2x4- 2x4 2.5x4-3 5x4 6x6- 6x7,5
1.5x3 2x4 12x4 1.5x7
Chat lipu Da trln Da trln Da trdn Da trln Da trln Da syn vanh tai Da diu manq toe
Da ddu manq t6c Da ddu manq t6c
Cudnq vat Xudi ddng Xudi ddng Xudi ddng Xudi donq Xudi ddng Nguac
ddnq Nguac
ddng Xudi dong Xudi ddng
SO-c sdnq 100% vat sSng
Bien chdnq Khdng Ton thuang
tk trin 3 vat ij- tTnh mach
Khdnq 1 vat u finh mach
Khdng Khdng Khdng Khdng
Kit qua xa Tit Hdi phgc sau 1 nSm
Vat CO ldm tri mi t&i phdt
Tit Vat CO. phii tao hinh blno vat khdc
Tit Tit T i l Tit 21
Y HOC THVC HANH (948) -: .. 1/2015
Trong s6 21 ton thuang ehO y l u Id khuylt da quanh m I t (16 ton thuang) vd mdt s l ton thuang viing da mang tde nhu da dau, Idng mdy, ria mPp.
Chu y l u Id cdc vat da d i u khong mang tde nhdnh
^ n xudi dPng dupe s u dyng Cd 1 vat da dau mang tdc nhanh trdn ngupe dPng ehe phii ton thuang Ichuylt da d i u do c h i n thuang, 1 vat da syn vanh tai r^dnh tran nguac ddng dung tao hinh khuylt ednh mui cung bdn. 3 vat da d i u mang tdc nhdnh tran xudi dPng d l tao hinh eung mdy vd ria mep. Hau h i t (17/21) cdc vpt d i u song vd eho k i t qua xa tuang d l i tit, dam bao chdc nang ehe phu vd dyng hinh (trong trudng hop tdi tpo cdnh mui. h i e mdt. todn bd ml dudi..), vat da cd mau s l e , dp day vd cau tnic da tuang ding vdi nai t i n thuang, benh nhdn hdi IPng v l ket qud phiu thupt. CP 4 vat bj d mdu tTnh mach trang 4 ngdy d i u . vat hong trd lai bat d i u t u ngdy thd 5. Trong nhdng trudng hpp nay vat bj co lai Idm eho mi dudi vd I mIt bi eo Ipi sau khi tao hinh.
BAN LUAN
Nhdnh trdn Id mpt trong hai nhdnh tpn eua dpng mach thdi duang nPng, tdch ra t u trPn cung gd md khoang 3cm. T u nguyen liy ddng mpch ndy ehpy Chech len trPn, vdo trong v l phia dudng giua trdn.
DOng mach thudng chay theo dudng chan tde TrPn dudng di eho ede nhdnh e l p mdu eho da, eo. xuang viing trdn. vd ede nhdnh e l p mdu eho da d i u mang tdc vitng dinh. Do vay, dya tren nhanh mach nay cd thi lly vpt da d i u mang tde hay da vOng Iran.
Vpt da d i u mang tde dupe sd dyng trong 4 trudng hpp. Ddy Id nhu'ng trudng hpp bj ton thuang da dau mang tdc viing dinh. khuyet eung may hay khuylt ria mdp. Vdi t i n thuang da d i u mang tde, chit lieu mang lai ket qua t h i m ml t i t n h i t duang nhiSn Id da d i u mang tdc. Tuy vay, da d i u vung trdn dinh r l t kPm di dpng, khPng t h i ddng true t i l p Han n&a, ede vat xoay eung khP huy dpng. Do dd, d l
ddng dupe ton khuylt e l n tao nhilu dudng rach rat ddi, d l Ipi nhilu seo d da dau. T i n thuang ria mPp va cung mdy sau khi lanh spo eP t h i theu hodc xdm len b l mdt seo. Tuy vdy, chi dp dyng dupx: vdi t i n thuang eung may d nu. Nam gidi khd c h i p nhpn phuang phdp ndy. GhPp phire hap da dau mang tdc t y do eung Id phuang phdp thudng dupe s d dyng tru'dc ddy, nhung sde s i n g eua mdnh ghep t y do kem han, thudng gdy aing tdc Idm cho tde, cung mdy, ria mPp bj thua, khdng dam bao v l mdt t h I m my. Han nu-a, manh ghep chi s i n g dupe trPn n I n t i n thuang giau mach mdu nen ehi djnh bj hpn e h l . Trong nhung tnj'Png hpp nay, vat da dau mang tde ed eulng maeh nudi thyc sy Id lya chon thich hpp.
C h i t lipu dua trPn nhdnh trdn dpng mpeh thdi duang ndng Id da dau khPng mang tPe vung trdn hay dupe s u dyng han vdi 16/21 ton thuang viing quanh d mat do cdc nguyPn nhdn khdc nhau NguyPn t i e cua phau thuat tao hinh Id chat lidu cang gan v| tri ton thuang thi mdu s l e , dp day mong vd tinh c h i t da cang phii hpp. Thyc t l Idm sang qua 16 trudng hpp nay, chiing tdi nhdn t h i y da trdn thich hap vdi tpo hinh khuylt p h i n m i m quanh I mIt' mi dudi, gdc mdt ngodi vd eung d l . Tuy vay, mpt trudng hpp vat duac su dyng d l tao hinh mi trdn qud day. Cd le do eau tnic da mi tren khd dpe biet. KhPng gilng nhu da d b i t kl viing ndo khdc, da mi trdn rat mong vd m i m mai. Do dd, ehi djnh dung vpt nhdnh trdn cho ton khuylt mi tren la chua hpp li.
Trong h l u h i t cdc trudng hpp, vpt dupe su dyng dudi dpng vat xudi ddng. Cd 2 trudng hpp vat dupe s u dyng dudi dang nguac ddng. Do ed sy tiep n l i phong phO giu-a nhdnh tran vdi cdc dpng mpeh Idn cdn nhu nhanh dinh vd nhanh tren I mdt cOng bdn va nhdnh trdn ben d l i dipn, cd the l l y vpt nhdnh trdn dudi dpng ngupe dPng md khdng anh hudng d i n sue s i n g eua vat.
Hinh 2: Vgt da dilu mang Idc nhdnh tran ngupe ddng tao hinh khuylt da dau
A. Tdn thuong va thiit ki tnrdc md; B: Vgt sau khi phiu tich; C Vat dwa din nai nhin; D: Sau md 1 tuin Tren ldm sdng gpp 4 trudng hpp vpt nhdnh trdn
xudi ddng d trp tTnh mpch trong 4 ngdy dau tien. T d ngdy thd 3, vpt bdt d i u sdng dan IPn vd vat hdng hodn todn d ngdy thd 5 Xem xPt Iai todn bp qud trinh phiu thupt, ehiing tPi t h i y 4 tnj'Png hpp ndy ed mdt dilm ehung Id khi gidi phdng cuong mpch da p h i u
tieh rat sdt ddng mach, lay kpm theo rat it cdn xung quanh mpch. Dieu ndy phii hop vdi k i t qua nghien cuu giai p h i u tnj'de ddy cua chiing tdi ve tTnh mach nhanh trdn trPn xde: chi cd 7/25 tiPu ban cd x u l t hiPn nhdnh trdn Idn vd 4/7 nhdnh trdn dd lai khdng dl ciing dpng maeh. Trong khi dP eo 20/25 tiPu ban m i y tTnh
Y HOC THUC HANH (948) - S6 1/2015
mpeh tiiy hdnh vdi dpng mpeh Id nhdng tTnh maeh r l t nhd. Cd the vipe phdu tieh qud sdt dpng mach trong qud trinh bde tdch eulng vpt da Idm t i n thuang nhdng tfnh maeh nhd ndy. Cde tru'dng hap sau ndy chOng tdi lay edn quanh eulng mach rpng han, tdi 3em, thi khdng edn gpp tinh trpng d trp tTnh mpch nda. Theo ede sdch giai p h i u thi cac nhdnh tTnh mpch trdn nhdn mau t d vOng da dau tuang dng, ludn di CLing vdi dpng maeh eung tPn sau do hoa nhpp vdi tTnh mach dinh thanh tTnh maeh thdi duang ndng r l i ciing tinh mpeh thai duong gida hap thanh tTnh maeh sau hdm. TTnh maeh sau hdm di xuIng qua phia sau ngdnh IPn xuang hdm dudi dl vdo tuyen mang tai. 6"
ddy tTnh mach nam ngodi ddng mach thai duang ndng vd dpng mpeh canh ngodi sau dd hap luu vdi tTnh mach mat do vdo tTnh mach canh trong. TTnh mpch thudng ehpy song song vdi dpng maeh, cdch dpng mach khoang 0,8em, ddi khi chay xa dpng mpeh, edeh dpng mpeh tdi 3cm thpm ehi khdng tim thiy tTnh mach di ciing dpng mpeh. Tuy vdy, g i n ddy cd khd nhieu quan niem khde nhau ve tTnh maeh trdn eOng nhu cdc tTnh maeh thupe hp tTnh mach thdi duang ndng. Ndm 2002, Nobuaki Imanishi bdo cdo k i t qua nghiPn cdu ve gidi phdu tTnh maeh thdi duang ndng. Quan d i l m eiia tde gia khde hdn vdi y vdn e l dien. Giai phdu dpng mpeh vd tTnh mach thdi duang nPng dupe phdn tich b i n g cdch ehup dpng mpch vd tTnh mpeh xdc sau khi duac tlPm c h i t mdu tuang phdn K i t qud cho thiy, ddng mach thdi duang ndng ludn dupe chla thdnh 2 nhanh nhu ede tde gid khde dd md td. Tuy nhlPn, giai phiu tTnh mpch thdi duang b i l n d l i r l t nhilu so vdi dpng mach. Nd ed t h i phdn chia thanh 1. 2 hope 3 nhanh. Trong 11 m l u nghien cdu, cd 5 mdu tTnh mach thai duang ndng ehia Id 2 nhanh ehinh, 3 mdu tTnh mach khdng chia thPm nhdnh chlnh ndo. 3 mau cPn Ipi sau khi ehia ra nhanh tran, nhdnh dinh Ipi tiep tue ehia ddi tao thdnh 3 nhanh tTnh mach chinh. Viing chia nhdnh cCia cdc nhdnh chinh eiia tTnh mpeh thdi duang nong rpng han Id viing ehia nhdnh eua dpng mach. Han nda, k i t qud chup dpng tTnh mpeh dd chdng minh mpt edeh rd rdng ring ngoai tru d d i u gan, tTnh mach thdi duang ndng khdng php thuPc vdo dpng mach. Cdc nhdnh dinh vd nhdnh trdn ciia tTnh maeh thdi duang ndng khde vdi dpng maeh tuang ung. cang ra ngoai vi nP cdng ehpy ra xa dpng mach. Trong khi dd, nhdnh dinh vd nhdnh trdn eiia dpng mach thdi duang nPng ed cac tTnh mpch mdng 6\ kem. Cac ITnh mpeh ndy b i t nguon t d d i u g i n eiia tTnh mach thdi duang ndng vd ehinh nhung tTnh mpeh mdng nay mdi dupe eol Id tTnh maeh tiiy hdnh ciia nhdnh dpng mpeh trdn vd dinh chd khdng phai Id cdc tTnh mach cOng tPn md cdc tdc gia tdng mP td. Cde tTnh maeh nay eho ede nhdnh v l phia da va n l i vdi mpng tTnh mach nong d trong idp da - cdi md dupe hinh thdnh bdi eac nhdnh ciia tTnh mach thdi duang ndng. Cau true tTnh mpch vung thdi duang dinh bao gdm ede tTnh mach nPng
vd tTnh mach tuy hdnh. Do dd, trong tm'dnLj hpp bPe vat khdng tim dupe tTnh mach eOng tPn thi ndn Idy rpng cdn quanh dpng mpeh d l bao ton eac tinh mgch mdng tiiy hanh dpng mpch. Vpy, vai trP ciia cde tTnh mpch mdng trong vipe dSn luu mau ddng maeh nhu the ndo, eP dam bao ddn luu mau khi khdng eP cdc tTnh mach nong ciing tdn vdi dpng mpch khdng? Dilu ndy ehua thay dupe chdng minh trPn lam sdng. Xem xPt hipn tuang d mdu tfnh mpch trong mpt s l vat trPn, ehung tdi cOng t h i y quan d i l m eCia Nobuaki Imanishi Id hap li. Tuy vdy, s6 luang bpnh nhdn trPn Id qud it d l ed the ehung minh.
K£T LUAN
CP t h i s d dyng nhdnh trdn dpng maeh thai duang ndng nhu nguon eung e l p mdu cho vat da khPng mang tde hodc da dau mang tPe, tiiy theo nhu c l u v l ehit lidu tao hinh trPn Idm sang. Nhd s u n l i tilp phong phii gi&a nhdnh trdn dpng mpch thdi duang ndng vdi nhdnh dinh vd dpng maeh trPn I mIt ciing bPn eOng nhu vdi nhdnh trdn bdn doi dipn dam bdo ed the lay vat ngupe ddng ma khdng anh hudng tdi sue s i n g vat.
TAI LIEU THAM KHAO
1. Dunham T (1893), "A method for obtaining a skin-flap from the scalp and a permanent buried vascular pedicle for covering defects of the face", Ann Surg. 17, tr. 677.-
2. LP Van San (2003), Phye hdi dc tdn khuyit vung him m^t bing vgt dn - ca thai duong., Ludn dn T i l n sT Y hpe, Tnj'Png Dpi hpc Y Ha Ndi.
3. D l Xuan Hpp (1978), "Giai p h i u d i u mdt c6", Nhd xuit bin Y hgc.
4. NguyPn Quang Q u y i n (2004). "Bdi giang Gidi Phau Hpe. Chi trPn - Chi dudi - Dau Mat C6". Nhi xuit bin Y hoc chi nhdnh TP. Hd Chi Minh. 1 (10), tr.
233-5.
5. Nguyin Vdn T h i n g (1998), "Nghien edu hp mpeh thdi duang ndng vd bude d i u dng dung trong phdu thuat tao hinh", Trwdng Dgi hgc Y Ha Ndi-
6. Esser JFS (1917), "Island flaps", A/Ymecf J, 5, tr. 106-264.
7. Hanjaki Sakurai Eiju Unehinuma, Nobuyoky Shioya, (1989), "Anterofrontal superficial temporal artery island flap for full thickness eyelid recons^ction", Ann Piast Surg, 23 (433).
8 Hidir Kilinc (2006), "A New Approach to Retroaurieular Flap Transfer Parietal Branch-Based Reverse Flow Superior Auricular Artery Island Flap ", Annals of Plastic Surgery, 56 (4), tr. 380-383.
9. Jineai Fan (2000), "A New Technique of Scarless Expanded Forehead Flap for Reconstructive Surgery", Piast Reconstr. Surg, 106 (777).
10. Fan J. (2009), "Aesthetic Full-Perioral Reconstruction of Burn Sear by Using a Bilateral- Pedicled Expanded Forehead Flap", Ann Piast Surg, 63, tr. 640-644.
Y HOC THVC H A N H (948) - SO | /2015
