artificial vaginal amniotic membrane transplantation

Artificial vaginal amniotic membrane transplantation for congenital non-vaginal treatment. Congenital absence of vagina is due to the influence of internal and external factors, resulting in the development or obstruction of the development of the end of the renal tube. Therefore, this type of patient has only a solid primordial uterus, the vagina is not developed; but the middle renal parane canal and genital warts develop normally, there may be normal fallopian tubes and ovaries, and women's secondary sexual characteristics develop normally, but patients are often accompanied by Developmental abnormalities in the urinary system and bones. At present, there are many surgical methods for the treatment of congenital absence of vagine in China. The earlier commonly used surgery has free skin graft, or pedicle flap transplantation and amniotic membrane transplantation. After that, Vechitti surgery was prevalent in foreign countries. In recent years, sigmoid colon transplantation, peritoneal transplantation and musculoskeletal vaginoplasty have been carried out at home and abroad, especially with the development of microsurgery, which has opened up a new way for this operation. However, these methods have their own advantages and disadvantages, and should be selected according to local medical conditions, technical level and psychological requirements of patients. Good vaginoplasty should be simple, once and for all, less damage, less complications, good efficacy, safe and reliable, economical and practical requirements, the current methods are not ideal, still need to continue to cover materials and surgical methods Innovative and perfect. Artificial vaginal amniotic membrane transplantation is easy to operate and has a high success rate. The resulting vaginal wall is mucosal tissue, which is lubricated and elastic, similar to normal vagina. However, it takes a long time for the vaginal wall to completely epidermis, and it needs to be worn with a long-term mold. In addition, during this period, infection is often caused, granulation is formed, local pain is caused, and the patient fears or even refuses to change and wear the mold, resulting in the formation of artificial cavity collapse. The scarring of scar formation and the failure of surgery is the biggest shortcoming of this law. Treatment of diseases: vaginal tumors congenital without vagina Indication Artificial vaginal amniotic membrane transplantation is applicable to: 1. Congenital without vagina, to solve the patient's sexual life. 2. Uterine or vaginal malignant tumors, most or all of the vaginal resection, in order to solve the patient's sexual life. Preoperative preparation Amniotic membrane preparation: Take a large block (20 ~ 28cm) fresh normal fetal delivery or selective cesarean section of fresh fetal membrane under aseptic operation, wash with sterile saline, peel off the chorion, and flatten the amniotic membrane The gauze soaked in saline is immersed in the antibiotic solution after folding (100,000 ml of physiological saline containing 100,000 U of penicillin and 1 g of streptomycin, stored in a refrigerator, and soaked for 2 hours). In order to maintain amniotic activity and toughness, the soaking time should not exceed 24 hours. Surgical procedure Artificial vagina See the related content of free layered skin. 2. Amniotic membrane transplantation 1 According to the size of the artificial cavity, the fixed vaginal speculum is placed on the double-layered condom, and the prepared whole amniotic membrane (the chorion contact surface is facing outward) is covered thereon, and the excess amniotic membrane on both sides overlaps. Need to suture; 2 gently wrap the amniotic membrane into the newly formed artificial cavity, and then fill the speculum with dry gauze or iodoform gauze strip; 3 separately remove the front and rear leaves of the speculum; 4 cut off the vagina Excessive amniotic membrane outside the mouth, the suture of the vestibular mucosa and the edge of the amniotic membrane were sutured and sutured. complication Slow growth of the above skin often leads to infection, wound congestion and edema, easy to grow granulation, especially at the vaginal apex. The occurrence of granulation can be asymptomatic or a small amount of vaginal discharge, but it hinders the growth of the epithelium and delays the healing. In addition to strengthening the anti-infective treatment, the granulation should be immediately applied to the chloramphenicol solution.