中华显微外科杂志最新文献

{"title":"The sensation recovery of superficial palmar branch of the radial artery flap with palmar branch of median nerve and donor site","authors":"Cunmin Rong, Yinlong Li, Fang Wang, Baoqiang Xu, Qinglin Zhang, Zhi Zhang, Hongjun Wang","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.008","url":null,"abstract":"Objective \u0000To explore the sensation recovery of superficial palmar branch of the radial artery flap with palmar branch of median nerve and donor site. \u0000 \u0000 \u0000Methods \u0000From January, 2014 to June, 2016, 12 cases of finger soft tissue defects were repaired with superficial palmar branch of the radial artery flap with palmar branch of median nerve. The 2 g tactile sensation, 5 g pain sensation, 30 g pressure sensation and static two-point discrimination(S2-PD) of the flap was tested regularly. The S2-PD of the palmar cutaneous branch of the median nerve were recorded respectively on the affected side and the unaffected side. The results were applied comparative t-test to perform statistical analysis, to observe the sensory recovery of the flap and donor site. \u0000 \u0000 \u0000Results \u0000The flaps survived. Twelve cases was followed-up for 6-18 months. The pressure sensation of about 83.3% of patients recovered after 2 months and 100% of patients recovered after 3 months. The tactile sensation of about 91.7% of patients recovered after 3 months and 100% of patients recovered after 4 months. The pain sensation of about 91.7% of patients recovered after 4 months of and 100% of patients recovered after 5 months. S2-PD of the flap was the average of 8.3 mm in 6 months after operation. There were no significant differences in the S2-PD between the affected group[ (12.08±2.15) mm] and unaffected group[ (10.58±2.11) mm](P>0.05). And the sensory recovery of the control area of the palmar branch of the median nerve was S4 in 2 cases, S3+ in 9 cases, and S3 in 1 case. The sensory recovery was good. \u0000 \u0000 \u0000Conclusion \u0000Superficial palmar branch of the radial artery flap with palmar branch of median nerve can be used repair the skin defect of the fingers. The flap has a good sensery recovery, and the sensation of the donor area is gradually restored. \u0000 \u0000 \u0000Key words: \u0000Superficial palmar branch of radial artery flap; Palmar branch of median nerve; Figer; Sensation reconstruction","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"446-449"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46078580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of pedicled flaps for defect reconstruction after resection of sarcoma around extremities joint in 103 cases","authors":"Xin Wang, Jiaqiang Wang, Weitao Yao, Z. Tian, Zhiyong Liu","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.012","url":null,"abstract":"Objective \u0000To investigate the clinical effect of using pedicled flap to reconstruct skin and soft tissue defect after resection of sarcoma around extremities joint. \u0000 \u0000 \u0000Methods \u0000Retrospectively analysis 103 cases of sarcoma around extremities joint who was treated from June, 2012 to June, 2017 and used the pedicled fasciocutaneous flaps or pedicled musculocutaneous flaps to reconstruct the defect after sarcoma resection. There were 61 males and 42 females, with a mean age of 52.3(14-82) years old. Among these patients, there were 32 initial diagnosis, 30 had been resected in other units, and 41 recurrent tumor. There were 13 patients that tumor around wrist: reconstructed by radial wrist upper branch fasciocutaneous flap, dorso-ulnar flap based on supracarpal perforator, and posterior interosseous artery flap. Eight patients with tumor around elbow: reconstructed by lateral arm flap and media arm flap. Eight patients with tumor around shoulder: reconstructed by latissimus dorsi musculocutaneous flap and lateral thoracic flap. Fourteen patients with tumor around hip: rectus femoris musculocutaneous flap, tensor fascia lata musculocutaneous flap, and posterior thigh fasciocutaneous flap. Sixteen patients that tumor around knee: reconstructed by anterolateral low leg flap, and sural calf fasciocutaneous flap. Forty-four patients that tumor around ankle: reconstructed by saphenous neuro-veno-fasciocu-taneous flap, sural neuro-veno-fasciocutaneous flap, lateral supramalleolar flap, and medial plantar flap. The defect area after tumor resection were: 3 cm×4 cm-18 cm×25 cm. After surgery, observe the situation and fitness of flap, complication, joint mobility, and tumor recurrence and metastasis. \u0000 \u0000 \u0000Results \u0000All flaps survived except 6 died or partial died, with a survival rate of 94.2%, of which dead flap were replaced by a new flap or covered by free skin graft. Infection occurred in 4 cases(2 in donor site and 2 in recipient site), were cured by dressing and antibiotic. Except for 12 cases dropped, all rest 91 cases were followed-up by 33 months on average (1-5 years), flaps' shape and texture were good, without swollen and fester, and fit well. Superficial sensibility of direct fasciocutaneous flaps and musculocutaneous flaps were normal, protective sensation of reverse fascial flaps were recovered. The mobility of affected joint show no difference compared with the other side. No ulcer occurred on flaps of plantar and buttocks, that helps normal sit position and gait. There were 17 recurrences and 32 metastasis occurred, 21 patients died so far. There was a statistical difference between recurrent cases with first shot(10.3%) second widely resection(11.5%) and recurrent resection(30.6%) (P<0.05) . \u0000 \u0000 \u0000Conclusion \u0000Using pedicled flap to reconstruct skin defect after the resection of sarcoma around extremities joint, can get good clinical result, with simple and reliable operation. It is worth to popularize. \u0000 \u0000 \u0000Key words: \u0000Limb wound; Malignant","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"464-468"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44213684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten years retrospective study of using primary microsurgery technology to treat patients with severe lower extremities injury","authors":"Y. Chai, Changqing Zhang","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.011","url":null,"abstract":"Objective \u0000To clarify the role of microsurgery in limb salvage procedure and its efficiency in longterm functional results through a retrospective review of patients who sustained severe injury of lower extremities and had been treated Shanghai 6th people's hospital, in recent 10 years. \u0000 \u0000 \u0000Methods \u0000Patients who sustained severe injury of lower extremities and treated with microsurgical techniques in January, 2006 to January, 2016 were studied. Patients' general information, classification of open fracture, and MESS were noted. The enrolled patients were divided into two groups(group A: primary microsurgical reconstruction; group B: non-microsurgical reconstruction) according to whether primary microsurgical reconstruction was performed or not. Each group were also further divided into subgroup according to preoperative MESS(MESS<7 and MESS≥7). The reconstruction methods, hospitalization days, operation times, postoperative complications, as well as the SIP were then recorded for each groups. The differences of these data among each groups were analyzed and compared. \u0000 \u0000 \u0000Results \u0000The main objection was patient with Gustilo grade III open fracture, totally 548 patients were admitted, with 312 males and 236 females. The main age was 35.6 years old. The main etiology was road traffic accident (79.7%). There were 211 patients (38.5%) in group A, and 337 patients (61.5%) in group B. In group A, there were 37 patients in subgroup one (MESS<7), and 174 patients in subgroup two(MESS ≥7). The rate of delayed amputation was 2.8%, while the complication rate was 11.8%. In group B, there were 181 patients in subgroup one(MESS<7), and 156 patients in subgroup two (MESS≥7). The rate of delayed amputation was 4.0%, while the complication rate was 13.3%. In long-term survey, the average VAS score of group B was higher than that of group A, but no significant difference was noted. The average VAS scores in 2 year postoperatively in the subgroups (MESS≥7) were higher than those in the other subgroups(MESS<7). The results of SIP scores were similar with VAS scores in two groups. \u0000 \u0000 \u0000Conclusion \u0000The techniques of microsurgery has been promoting the successful rates and outcomes for limb salvage procedure over the recent decades. Meanwhile, the current evaluating system for severe limb injury needs to be updated to meet the demands of ever-developing limb salvage techniques. \u0000 \u0000 \u0000Key words: \u0000Severe lower limb injury; Limb salvage; MESS; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"459-463"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45804965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of soft tissue defect in non-weight-bearing area of the foot with trimmed free anterolateral thigh muscle flap combined with skin grafting","authors":"Rui Hu, Yijun Ren, Li Yan, Xi Chen, Keke Cheng, Shanqing Li, S. Liao","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.005","url":null,"abstract":"Objective \u0000To investigate the clinical effect of reconstruction of soft tissue defect in non-weight-bearing area of the foot with trimmed free anterolateral thigh muscle flap combined with skin grafting. \u0000 \u0000 \u0000Methods \u0000From January, 2009 to January, 2017, 25 patients with soft tissue defect in foot and ankle were treated with transplantation of the trimmed free anterolateral thigh muscle flap combined with skin grafting. Of the 25 cases, there were 5 cases located in medial foot, 10 cases in dorsum of foot, 7 cases in external of foot and 3 cases in the toe. The areas of wounds were 8.0 cm×6.0 cm to 18.0 cm×10.0 cm. The anterolateral thigh muscle flap was from 4.0 cm×3.0 cm×0.3 cm to 10.0 cm×8.0 cm×1.5 cm. All the cases were operated in fracture fixation and wound without obvious infection. Early rehabilitative exercise under the protection of orthosis were done after 4 weeks of the operation and to assess. The injuried limb function were assessed in 1 year postoperatively according to Marylands scale. \u0000 \u0000 \u0000Results \u0000All cases were followed-up for 12 to 24 months (average, 16.2 months) . All the muscle flaps and skin survived. The healing time were 12 to 24 days, averaged of 17.1 days. Patients could wear shoes normally and resume normal life and work. The appearance and walking function were satisfying and no further debulking procedures were needed. The surgery function were assessed according to Marylands scale, and the results was 22 cases for excellent, and 3 cases for good. \u0000 \u0000 \u0000Conclusion \u0000Ttrimmed free anterolateral thigh muscle flap combined with skin grafting is a good option for the repair of foot and ankle defect at non-weight-bearing area, and it has the advantages such as the doner site is small invasive, the muscle flap is easy to be harvested, and can avoid debulking surgery to wear shoes normally. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh muscle flap; Foot; Transplantation; Soft tissue defect; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"433-436"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48183459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the reliability of NIRS to monitor fibular flaps on Rhesus monkeys","authors":"S. Ouyang, X. Shan","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.04.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.04.011","url":null,"abstract":"Objective \u0000To confirm the sensitivity and validity of near-infrared spectroscopy (NIRS) technology to detect the dynamic changes of blood volume and regional tissue oxygen saturation (rSO2). \u0000 \u0000 \u0000Methods \u0000Six fibular flaps on Rhesus monkeys were raised simulating a clinical operation. Third generation of NIRS oxygen saturation oximeter (TSAH-100) was employed on Rhesus monkeys’ fibular flaps when its dominant artery and vein were blocked respectively or simultaneously, and then their relative changes of blood volume and oxygen saturation were observed and recorded in June, 2008 to October, 2008. \u0000 \u0000 \u0000Results \u0000The statistic results showed that concentration of deoxygenated hemoglobin (cHb), concentration of oxyhemoglobin (cHbO2) and rSO2 had rapid, apparent and distinct changes respectively in the case of arterial occlusion, venous occlusion and total occlusion. The initial values of cHb and cHbO2 of 3 models were 0 μmol/L. Meanwhile, the initial values of rSO2 in artery embolism, vein embolism and arteriovenous embolism were 51.6%, 54.3% and 56.8%, respectively. The maximum variations of cHb, cHbO2 and rSO2 in 3 models indicated significant difference compared with initial values (P<0.05) , the values of rSO2 after 6 s, 18 s and 8 s in 3 models had significant difference compared with initial values respectively (P<0.05) . \u0000 \u0000 \u0000Conclusion \u0000The TSAH-100 based on NIRS technology is an extraordinarily sensitive and reliable method to monitor the changes of oxygen saturation and blood perfusion in local tissue for buried flap within a depth of 2.0 cm. \u0000 \u0000 \u0000Key words: \u0000Near-infrared spectroscopy (NIRS); Oxygen saturation; Fibular flap; Buried flap; Rhesus monkey","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"360-364"},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42424631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic feature of the adjacent perforator fasciocutaneous flap of plantar and its clinical application","authors":"Jing Wang, Xiao-jing Li, Jin-long Ning, Xin-yi Li, M. Tang","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.04.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.04.009","url":null,"abstract":"Objective \u0000To study the anatomic basis and its clinical effects of the adjacent perforator fasciocutaneous flap in planta. \u0000 \u0000 \u0000Methods \u0000From October, 2010 to December, 2017, the work was on two fronts:① The blood supply of the flap was studied by the dissection of 5 adult lower limbs which were perfused with red emulsion. Under the magnifying glass, the source of blood supply to the pedicle perforator fasciocutaneous flap near the foot was observed, and the caliber of perforating vessels was measured by vernier caliper. ② Methods based on the anatomic study, the adjacent perforator fasciocutaneous flap was designed to repair plantar defect. Eleven cases with defects in planta were treated with the flap including 5 malignant melanoma, 5 refractory wound and 1 pigmented nevus. The size of defects ranged from 1.5 cm×2.0 cm to 4.0 cm ×5.0 cm with the size of the flaps ranging from 7.0 cm×3.0 cm to 13.0 cm×7.0 cm. \u0000 \u0000 \u0000Results \u0000Anatomical studies showed that the supply vessels of the fasciocutaneous flap near the perforator of the plantar space were plantar medial arteries. The external diameter was greater than or equal to the 0.5 mm perforating number of about 7, the average outer diameter was (0.85±0.19) mm. The medial plantar artery emits multiple branches along the running direction and forms anastomotic branches in the arch of the foot to ensure the blood supply of the flap. Eleven cases of perforator fasciocutaneous flaps survived, including 1 case of distal necrosis of small area and healed after change dressings. The follow-up results during 6-24 months showed that all patients were walking normally, with full texture and no localized dull pain. \u0000 \u0000 \u0000Conclusion \u0000On the basis of the extent of diseases, projected the adjacent perforator fasciocutaneous flap, the wear resistance and abrasive resistance are improved resulted from flaps with similar skin texture of defects. The donor site can be closed directly without skin graft. It is an simple and reliable method to repair medium and small- sized plantar defects. \u0000 \u0000 \u0000Key words: \u0000Plantar; Perforator flap, fasciocutaneous flap; Applied anatomy; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"352-355"},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41899641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The study for induction and differentiation of rat’s adipose-derived stem cells by valproic acid in vitro","authors":"Fei Wu, Ting Jia, Yue Yang, Zhibo Sun, Feng Liu","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.04.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.04.010","url":null,"abstract":"Objective \u0000To study the inducting differentiation effects of the vaproic acid (VPA) on rats adipose derived stem cells (ADSCs) in vitro. \u0000 \u0000 \u0000Methods \u0000From November, 2016 to October, 2017, the ADSCs were isolated from 2 healthy 3-weeks-old Sprague-Dawley (SD) rats and cultured to passage 3, which were treated with 10 ng/ml bFGF for 24 hours before induction. Then the induction media contained the VPA with different concentrations: group B (0.5 mmol/L, 200 μl) VPA; group C (1.0 mmol/L, 200 μl) VPA; group D (10 mmol/L, 200 μl) VPA, and D-Hank was used in group A as blank control group. The morphological changes of the cells were observed every day. At 7 days of induction, the gene expressions of neuron-specific enolase (NSE), nestin (NES), and S-100 were detected by real-time fluorescent quantitative PCR. The S-100 protein expression was tested by immunofluorescence staining. Significance of difference was determined using independent t test. Probabilities lower than 5% (P < 0.05) were considered statistically significant. \u0000 \u0000 \u0000Results \u0000At 4 days after induction, some ADSCs of groups B, C, and D showed the morphology of Schwann-like cells or neuron-like cells, the change of group C was more obvious; and the ADSCs of group A had no obvious change, which still present spindle. The S-100 immunofluorescence staining showed higher ratio of positive expression in groups B, C, and D (more obvious in group C) and lower ratio of positive expression in groups A and D (more obvious in group A). The gene expression of S-100 showed dose-dependent increases in groups C, which was significantly higher than that of groups A, B, and D (P 0.05). The gene expression of NSE showed the same tendency as S-100, which reached the peak in group C; the gene expression of NSE in group C was significantly higher than that of groups A, B, and D (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000ADSCs can be induced to differentiate into Schwann-like cells or neuron-like cells under the treatment of VPA, and 1.0 mmol/L is the optimal concentration. \u0000 \u0000 \u0000Key words: \u0000Adipose-derived stem cells; Schwann cells; Valproic acid; Induction and differentiation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"356-360"},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46736108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and clinical application of postoperative marker system of perforator flap","authors":"Guangxun Zhao, F. Hu, Jin Wang, Guang Yang, Lei Shi, Tian Xia","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.04.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.04.007","url":null,"abstract":"Objective \u0000To investigate the design of the postoperatively marker system based on the perforator flap and its clinical application. \u0000 \u0000 \u0000Methods \u0000According to the basic anatomy and blood supply characteristics of perforator flap, the observation points were marked on the flap surface and recipient area postoperatively, and judge flap blood flow changes with hand-held Doppler(HHD) and clock-face measurement based on perforators. From November, 2015 to November, 2017, prospectively conducted a control study evaluating the incidence of vascular crisis, accuracy rate, reoperation rate and survival rate of flaps between simple traditional flap monitoring group (n=100) and traditional flap monitoring combine with postoperatively marker system monitoring group (n=100). \u0000 \u0000 \u0000Results \u0000Vascular crisis was mostly concentrated with in 48 h postoperative in traditional flap monitoring group and combined group. There was no significant difference in the incidence, positive rate and negative rate of vascular crisis in the two groups (P>0.05). The reoperation rate in the traditional flap monitoring group (87.5%) was higher than the combined group (27.8%)(P<0.01). The survival rate of flap of combined group (99%) was higher than the traditional falp monitoring group (90%) (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The postoperatively marker system of perforator flap can effectively guide the medical staff to observe the blood supply of the flap, detect and judge the vascular crisis in time, and It is simple and easy to do without increasing the patient’s trauma and medical expenses as well as no additional equipments. \u0000 \u0000 \u0000Key words: \u0000Perforator flap; Postoperatively marker; Hand-held Doppler ultrasound; Vascular crisis","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"343-347"},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41888690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow-through anterolateral thigh flap transfer combined with bone transport technique for repairing the segamental mutilating injury in lower extremity","authors":"Yongming Guo, Zhong Liu, Yun-sheng Teng, Meng Wu","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.04.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.04.002","url":null,"abstract":"Objective \u0000To explore the clinical application and effect of Flow-through anterolateral thigh flap transfer combined with bone transport technique for repairing the segamental mutilating injury in lower extremity. \u0000 \u0000 \u0000Methods \u0000From June, 2010 to June, 2016, Flow-through anterolateral thigh flap transfer combined with Ilizarov technique were applied to repair the segamental mutilating injury in lower extremity in 10 cases. Of the 10 cases, there were 8 males and 2 females (their ages ranged from 26 to 55, 36 on average). Four caused by road accident, 4 caused by crush injury, 2 cases caused by squeeze injury. First stage, Flow-through anterolateral thigh flap transfer were applied to revascularize the lower limb and repair the soft tissue defect in emergency. Second stage, bone transfort with external fixator were applied to repair bone defect in second stage. The area of the flap ranged from 12.0 cm×15.5 cm to 20.0 cm×25.0 cm. The repair of bone defect ranged from 4.0 cm to 10.0 cm. Time interval between two stages ranged from 2 to 4 months, 3 months on average. Followed-up method was regular outpatient-care after discharge. The main contents include: the presence of red swollen with pus, the condition of infection in the pin, if the fixed pin was loosening, and adjust the speed of bone transport according to the mineralization of new bone. \u0000 \u0000 \u0000Results \u0000All cases were successfully repaired in 10 cases. Ten cases were followed-up with a mean followed-up time of 42 months. All flaps survived, in with 6 cases were healed in first stage, 4 case were healed in second stage (healing time ranged from 14 to 30 days), and bone transfort time ranged from 6 to 16 months. The docking site union occurred in 6 cases and were healed by use of bone debridement, bone graft and compression. Deformity in foot and ankle occurred during the bone transport in 2 cases and were cured by draft therapy with adding ring fixator. The functions of donor sites were not found malfunctional. \u0000 \u0000 \u0000Conclusion \u0000Flow-through anterolateral thigh flap transfer combined with bone transport have high success rate of limb salvage, good quality of osteogenesis, and satisfactory function recovery. It is an optimal method to repair the segamental mutilating injury of the lower extremity. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh flap; Flow-through flap; Bone transport technique; Segamental mutilating injury; Lower extremity","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"319-323"},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48891558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of anterior inferior cerebellar artery by occipital artery through extended retrosigmoid approach","authors":"Yuan Li, Jianrui Sun, Bo Yang, Shu-kai Wang","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.04.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.04.012","url":null,"abstract":"Objective \u0000To explore the feasibility of occipital artery(OA) to anterior inferior cerebellar artery (AICA) through the extended retrosigmoid approach, also perform a systemic microanatomical study of OA and AICA with the exposure of extended retrosigmoid approach, find the easy way to perform the procedure. \u0000 \u0000 \u0000Methods \u0000From September, 2016 to January, 2017, 5 adult cadaveric heads injected with colored latex (total 10 sides) were performed the extended retrosigmoid approach, and measured the caliber of distal occipital artery (OA), the final length of the OA harvest, the reliable landmark of the OA harvest, and the distance from the flocculonodular segment of anterior inferior cerebellar artery (AICA) to the OA, the diameter of AICA flocculonodular segment branch. Whole procedure of OA to IACA bypass also be performed. Statistical analysis was performed. \u0000 \u0000 \u0000Results \u0000By the extended retrosigmoid approach, AICA flocculonodular segment could be easily exposure, the average diameter was 1.2 mm, the OA branch could be harvested in average was (72.3±3.3)mm in length from the occipital sulcus, and the average distance between occipital sulcus and AICA flocculonodular segment was (47.6±1.9)mm. The bypass procedure also could be performed through the proper corridor. \u0000 \u0000 \u0000Conclusion \u0000The Extended retrosigmoid approach is a safe and efficient way to perform the OA-AICA bypass procedure, and the procedure is easier to be performed than other surgical approaches. \u0000 \u0000 \u0000Key words: \u0000Occipital artery; Anterior inferior cerebellar artery; OA-AICA bypass; Extended-retrosigmoid approach; Applied anatomy","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"365-367"},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47363456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}