中华显微外科杂志最新文献

{"title":"Transplantation of slice nail bed flap of great toe with vascular anastomosisin repairing nail bed and soft tissue defect of fingers","authors":"Muwei Li, Lifeng Ma, Honggang Wang, Shaogeng Huang, Gong Wu, Zhe Zhang, Yanjun Yang, Ziqing Zhang","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.01.003","url":null,"abstract":"Objective \u0000To discuss the clinical effect of transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers. \u0000 \u0000 \u0000Methods \u0000From January, 2015 to March, 2018, 16 cases (16 fingers) of partial nail-bed defect at fingers were repaired with transplantation of slice nail bed flap of great toe with vascular anastomosis. All cases were combined with palmar soft tissue defect at distal segment fingers. The area of nail bed defects were from 0.8 cm×0.5 cm to 1.2 cm×1.0 cm. The area of soft tissue defects were from 1.2 cm×1.0 cm to 2.5 cm×1.5 cm. The average time from injury to operation was 3.6 hours after injuries(ranging from 1 hour to 8 hours). The area of slice nail bed flap incised during operation were from 2.5 cm×1.2 cm to 3.2 cm×1.8 cm, and the donor site was sutured directly. All patients were followed-up regularly for nail appearance, function and donor healing. Among them, 11 cases were followed-up by clinic, 4 cases by WeChat, and telephone follow-up was performed in 1 case. \u0000 \u0000 \u0000Results \u0000The nail-bed flap after transplantation survived successfully. The followed-up time were from 6 to 18 months, the average time was 9 months. Longitudinal spine and rough appearance occurred in 1 case. Others were flat, smooth, complete attachment of nail body and nail bed. The flaps had good appearance, texture and elasticity at 6 months after surgery, and two-point discrimination was 6-12 mm(average, 8 mm). The toenails at donor sites grew well. No walk-associated pain after long-term following-up. Six months after surgery, according to standard for efficacy evaluation of nail regeneration, 12 cases were excellent, 3 cases were good and 1 case was acceptable. \u0000 \u0000 \u0000Conclusion \u0000Transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers is one of the effective methods for repairing nail-bed defect at fingers. \u0000 \u0000 \u0000Key words: \u0000Nail bed defect; Nail bed fiap of great toe; Vascular anastomosis; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44041424","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":"Application of double-leaf perforator free flap of posterolateral calf peroneal artery in repairing facial through-and-through defect after oral cancer oblation","authors":"Jian-cheng Li, Peijun Song, Dongkun Yang, Liang Liu, K. Hu, Mo Chen","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.01.008","url":null,"abstract":"Objective \u0000To evaluate the effect of double-leaf perforator free flap pedicled with posterolateral calf peroneal artery on repairing facial through-and-through defect after oral cancer oblation. \u0000 \u0000 \u0000Methods \u0000Nine patients with facial through-and-through defects after oblation of oral and maxillofacial malignancies, including 4 cases of buccal mucosa carcinoma, 2 cases of maxilla osteosarcoma, 1 case of carcinoma of the maxillary sinus and 2 cases of parotid duct carcinoma, were recruited from May, 2016 to May, 2018. The flap was used to repair the facial defect of recruited patients. The area of the bigger leaf of bilobed perforator flap was 7.0 cm×8.0 cm-6.0 cm×7.0 cm and the small leaf was 4.5 cm×4.5 cm-4.0 cm×4.0 cm, respectively. The intraoral and facial defects needed to be reconstructed contained the oral mucosal of the upper palate, the skin, subcutaneous tissue and mucosa of the cheek. The radiotherapy was performed 1.0-1.5 months after the operation. The prognosis including appearance, mouth opening, and the functions of deglutition, and language were assessed. \u0000 \u0000 \u0000Results \u0000Through 3-18 months outpatient followed-up, all 9 cases of transplanted flaps survived well and the incisions of the donor and recipient areas healed by first intention. The patients were satisfied with the facial appearance, mouth opening, and the functions of deglutition and language at the 6 months follow-up. The radiotherapy had no damage on the survival of the bilobed perforator flap. There was no recurrence or metastasis in follow-up. \u0000 \u0000 \u0000Conclusion \u0000The double-leaf perforator free flap pedicled with posterolateral calf peroneal artery is an ideal free tissue for repairing the facial perforating defect after oral cancer oblation because of its constant blood vessel, abundant tissues, flexible design and operating methods. \u0000 \u0000 \u0000Key words: \u0000Oral cancer; Through-and-through defect; Double-leaf perforator free flap; Peroneal artery; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69872094","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":"Repair of soft tissue defect around posterior calcaneal region combined with Achilles tendon defect by the thin-layer free anterolateral thigh flap with iliotibial band","authors":"Changshun Chen, Xiang Hu, Qianjin Zheng","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.01.010","url":null,"abstract":"Objective \u0000To investigate the clinical effect of thin-layer free anterolateral thigh flap with iliotibial tract for reconstruction of heel soft tissue and Achilles tendon defect. \u0000 \u0000 \u0000Methods \u0000From January, 2017 to December, 2017, 11 cases of heel soft tissue and Achilles tendon defect were repaired by thin-layer free anterolateral thigh flap with iliotibial tract. There were 5 cases with tibia/fibula fracture, 3 cases with ankle fracture and 1 case with calcaneal fracture. The area of soft tissue defect was 6.5 cm×10.0 cm-8.0 cm×13.0 cm, and the length of Achilles tendon defect was 5.5-11.5 cm. All wounds were treated with debridement and negative pressure sealing drainage technique at first stage. After 6 days, the soft tissue defect around posterior calcaneal region combined with Achilles tendon defect were repaired by the thin-layer free anterolateral thigh flap with iliotibial tract. Reasonable rehabilitation training was established after operation. \u0000 \u0000 \u0000Results \u0000The flaps survived in 11 cases and the donor region healed in one stage. The patients were followed-up for 8 to 20(mean, 15.74) months by outpatient review, calling or WeChat. Slightly bloated in appearance in 2 cases, and were thinned by orthopedic operation 1 year later. The other flaps were well shaped and moderately thick. At the last follow-up, the flaps were soft in texture and elastic. The sensory recovery of the flap was good, and the two-point discriminant perception in the posterior region of the heel was 3.0-5.0(mean, 4.11) mm. Thompson’s sign was negative, double or one-foot heel lift test was negative, and there was no recurrence of Achilles tendon rupture or skin ulceration in the heel region. The range of motion(ROM) of affected side was (23.11±1.17)°of extension and (43.67±1.06)° of flexion, and the ROM of normal side was (23.79±1.03)°of extension and (44.03±0.94)°of flexion. There was no statistical difference between them(P>0.05). Postoperative follow-up was conducted according to the Thermann’s function evaluation system, the evaluated result was excellent in 8 cases, good in 2 cases, and receivability in 1 case. \u0000 \u0000 \u0000Conclusion \u0000It is a reliable and effective method to repair heel soft tissue and Achilles tendon defect by thin-layer free anterolateral thigh flap with iliotibial tract. And this method can better restore foot ankle shape and function. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh flap; Iliotibial band; Heel; Achilles tendon defect; Microsurgical operation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49392032","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":"Anatomical basis of the V-Y advancement flap based on the dorsal carpal perforators","authors":"D. Hu, Xiao Zhou, Wenming Zhang","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.01.012","url":null,"abstract":"Objective \u0000To provide anatomical basis for the design of the V-Y advancement flap and investigate the morphological characters of the dorsal carpal perforators. \u0000 \u0000 \u0000Methods \u0000From August, 2017 to October, 2018, 30 sides adult specimens of hand were perfused with red latex. The following contents were observed under surgical magnifier: ①The origin, courses, branches, and distribution of the dorsal carpal perforators. ②The characters of dorsal carpal perforators in agreement with the antebrachial and dorsal metacarpal vascular net. \u0000 \u0000 \u0000Results \u0000The dorsal carpal vascular network was composed of deep vascular network (bone and joint network) and superficial vascular network (fasciocutaneous network). The deep vascular network was located at the deep aspect of the extensor tendons and was commonly formed by dorsal carpal branch of radial artery, dorsal carpal branch of anterior interosseous artery, ascending branch of the dorsal carpal perforator from the deep palmar arch, and dorsal carpal branch of ulnar artery. The superficial vascular network was located on the surface of the extensor tendons and was mainly formed by dorsal carpal branch of radial artery, dorsal carpal branch of ulnar artery, dorsal carpal branch of anterior interosseous artery, radial and ulnar myocutaneous branches of posterior interosseous artery, and the perforators from the deep vascular network. The 3rd and 4th perforators puncturing out from the ulnar and radial margins of the extensor tendon had a constant occurrence rate (100%) with an outer diameter of (0.7±0.3) mm and (0.6±0.2) mm, respectively, and a length of (1.1±0.4) cm and (0.9±0.4) cm, respectively. They were divided into the ascending branch, descending branch, and collateral branch. And finally anastomosis with antebrachial and dorsal metacarpal perforators. \u0000 \u0000 \u0000Conclusion \u0000The V-Y advancement flap based on the dorsal carpal perforators can be a good choice for restoring the dorsal metacarpal defects. \u0000 \u0000 \u0000Key words: \u0000The dorsal carpal perforators; Perforator flap; Advancement flap; Applied anatomy","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47652879","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":"Replanting the complex amputated thumb with the pedicled flap from the rasceta area","authors":"Zhangcan Li, Dawei Zheng, W. Qi, Hui Zhu, R. Shi, K. Shou","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.01.005","url":null,"abstract":"Objective \u0000To explore the operative method and effect of replantation of complex severed thumb with the pedicled flap from the rasceta area. \u0000 \u0000 \u0000Methods \u0000From March, 2015 to March, 2017, 12 cases of complicated thumb injury were treated by retrograde transfer flap pedicled with the superficial palmar branch of the radial artery. All digital arteries defective with soft tissue defect, the area was 1.5 cm×3.0 cm to 5.5 cm ×7.0 cm. The wound of the wrist donor site was sutured directly. Postoperative followed-up was performed to review if the flap survival. \u0000 \u0000 \u0000Results \u0000There was 1 case of venous reflux disorder. After removal of some sutures, the symptoms were relieved. All other fingers survived successfully, and the flap survived completely. The donor site incision healed at I stage. The followed-up period was 12-18 (average, 13.5) months. The appearance of the thumb and flap was satisfactory, and the scar in the donor site was not obvious. The thumb function was evaluated according to the evaluation standard of thumb and finger reconstruction function of the Chinese society of medical surgery. Eight cases were excellent, 3 cases were good, and 1 case was medium. \u0000 \u0000 \u0000Conclusion \u0000The pedicled flap from the rasceta area has the advantages of simple operation and reliable blood supply. It can reconstruct the defect vessels and repair the wound at the same time. It is a new method for replantation of complicated severed thumb. \u0000 \u0000 \u0000Key words: \u0000Wrist transverse flap; Severed finger; Replantation; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"13-16"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48814120","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":"Microsurgical repair of soft tissue necrosis after beak-type calcaneal fracture in 8 cases","authors":"R. Su, Pei-Ji Wang, Y. Gu, Xiu-hui Wang, Zhicheng Zuo, Jiajun Zhao, Beigang Fu, Jiajun Wu, Chao Shen","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.01.007","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of microsurgical repair of soft tissue necrosis after beak-type calcaneal fracture. \u0000 \u0000 \u0000Methods \u0000From January, 2012 to March, 2017, surgically flaps were used to repair wounds in 8 patients with soft tissue necrosis after calcaneal beak fracture. Five patients underwent sural neurovascular flap in the first stage of repair, 2 patients were treated with peroneal perforator propeller flap, and 1 patient was treated with posterior tibial artery perforator propeller flap. The donor sites of 3 flaps were directly closed, and donor areas of the remaining 5 were covered with medium-thickness skin grafts without being sutured directly. The size of flap was 5.0 cm × 3.0 cm-7.0 cm × 5.0 cm. Through postoperative outpatient and WeChat follow-up. The patient’s flap survival, infection, flap shape, sensation and ankle function were evaluated. \u0000 \u0000 \u0000Results \u0000All flaps and skin grafts survived post-operatively. All patients were followed-up for 6-12 (mean, 8.4) months. All patients had good flap survival and no complications such as soft tissue and calcaneal infection. The flaps were good in texture, shape and function of ankle. At the last follow-up, according to the British Medical Research Institute (BMRI), the sensory function was divided into 6 levels. The flap sensory function recovered to S2 in 3 cases, and the remaining 5 cases was S1. According to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-hindfoot Scale (AHS), the results were excellent in 5 cases, and good in 3 cases. All patients had good clinical results and satisfaction at the last followed-up. \u0000 \u0000 \u0000Conclusion \u0000The treatment of soft tissue necrosis after calcaneus beak fractures can be completed in one stage by using flaps, which avoided the occurrence of calcaneal osteomyelitis. It is easy to perform early rehabilitation exercise and the ankle function is well restored. \u0000 \u0000 \u0000Key words: \u0000Calcaneus; Beak fracture; Propeller flap; Sural neurovascular flap; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47253968","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":"Anterolateral musculocutaneous flap for reconstruction of bone expose of lower leg amputation stump which on the verge of reamputation","authors":"Yi Zhan, Jian Qi, Xiang Zhou, Guo Fu, Dong Wang, Q. Zhu, Liqiang Gu","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.001","url":null,"abstract":"Objective \u0000To explore the curative effect of anterolateral musculocutaneous flap to repair the soft defect of the lower leg amputation stump which on the verge of reamputation, and preserved the length of leg or the knee joint to improve prosthetic limb function. \u0000 \u0000 \u0000Methods \u0000Four patients with soft defect and bone expose of proximal leg amputation stump were enrolled in this study from April, 2013 to November, 2016. Each patient underwent stump revision using anterolateral musculocutaneous flap, including 3 free musculocutaneous flaps and 1 pedicle musculocutaneous flap. The patients were all male with the mean age of 20(8-48) years. The wound was treated debridement, and reconstructed on the second stage. Defect area was from 7.0 cm×6.0 cm to 25.0 cm×10.0 cm. Anterolateral musculocutaneous flaps was from 13.0 cm×10.0 cm to 28.0 cm×12.0 cm. The length of preservation tibia stump was from 5.2 cm to 9.4 cm. \u0000 \u0000 \u0000Results \u0000All patients were followed-up from 12 months to 37 months (average, 19 months). All the musculocutaneous flaps survived completely with a soft tissue texture, elastic, and very wear-resisting. The sensory return was determined to be S2 in 2 patients, S3 in 1 patient and S3+ in 1 patient. The 6-Minute Walk Test: grade IV in 2 cases, grade III in 2 cases; Stanmore movement classification: gradeV in 2 cases, grade IV in 2 cases. \u0000 \u0000 \u0000Conclusion \u0000The anterolateral musculocutaneous flap maybe is an ideal flap to provid stable coverage for the stump of leg amputation which on the verge of reamputation. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh musculocutaneous flap; Amputation; Reconstruction; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"521-524"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49576350","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":"Microsurgical repair of ring avulsion injuries","authors":"Yu-zhou Liu, Yongjun Rui, Zhengfeng Lu, Suming Wei","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.009","url":null,"abstract":"Objective \u0000To investigate the clinical effect of microsurgical repair after ring avulsion injuries. \u0000 \u0000 \u0000Methods \u0000From March, 2009 to December, 2014, 6 cases (6 fingers) of ring avulsion injury were repaired. There were 4 males and 2 females with an age range of 18-30(mean, 22) years, which were 4 cases of ring finger and 2 cases of middle finger. The plane of injury was metacarpophalangeal band. Fracture and dislocation was reduced and fixed if damage fingers following with fracture and dislocation of interphalangeae. The damage ligament and volar plate and extensor tendon was repaired. The digital arteries and veins were repaired, and the digital nerves were sutured. System rehabilitation exercise carried out postoperatively. \u0000 \u0000 \u0000Results \u0000All fingers survived, and were followed-up for 8 to 30 months. The appearance of the fingers was excellent. The avarege range of motion of the proximal interphalangeal was 80°(ranged from 70° to 100°). The distal interphalangeal was 50° (ranged from 40° to 60°). The sensory recovery of finger pulp ranged from S3 to S3+. The two-point discrimination was 5 mm to 12 mm. According to the Evaluation Criteria for Finger Replantation and Reconstruction Issued by Chinese Hand Surgery of Chinese Mdical Association, 4 fingers had excellent while 2 had fairly good function. \u0000 \u0000 \u0000Conclusion \u0000Microsurgical repair of ring avulsion injury can achieve satisfactory clinical results by rehabilitation exercises postoperatively. \u0000 \u0000 \u0000Key words: \u0000Fingers; Ring avulsion injury; Repair; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"556-558"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46029955","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":"Reading man flap for repair of soft tissue defects in distal fingers","authors":"Ting-gang Chu, Haiting Xu, Li Shi, Yong-huan Song, Zhijie Li, Chen Xinglong","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.010","url":null,"abstract":"Objective \u0000To explore the Reading man flap for the treatment of soft tissue defects in distal fingers. \u0000 \u0000 \u0000Methods \u0000From May, 2014 to June, 2017, Reading man flaps were transferred in the emergency room to repair soft tissue defects in distal fingers in 46 patients. There were 28 cases of finger pulp defects, 6 cases of dorsal defects and 12 cases of finger stump defects with the size of soft tissue defects ranged from 1.0 cm×0.9 cm to 2.2 cm×2.0 cm (average, 1.2 cm×1.3 cm). The volar, dorsal and hybrid flaps were 28, 6 and 12 cases respectively. The average size of the major flap and minor flap were 1.8 cm×1.2 cm and 1.4 cm×0.8 cm, respectively. All donor sites were sutured directly. All patients were followed-up by review in the outpatient department. \u0000 \u0000 \u0000Results \u0000The consumed operative time was 35-48 min, with an average of 37.8 min. Prophylactic antibiotics and wound dressing were conducted postoperatively. The tip of the minor flaps occurred inflammation and small blister in 2 cases and eased by removal of the tip sutures. Traumatic neuralgia occurred in 1 case and self-healed after 3 months. Twenty-six cases were followed-up at least 11 months, which were 16 cases of finger pulp defects, 3 of dorsal defects and 7 of finger stump defects. On an average of 10.5 (9-27) months followed-up, all flaps survived. Except 4 cases with slim hook nail deformity, the remaining flaps were observed with satisfactory texture and appearance, the bulky deformity and scar contracture did not occur. Two points distinguishment on the major and minor flaps were 3.3-6.2 (average, 4.5) mm and 5.5-9.8 (average, 7.1) mm respectively. According to the Trial Standard for Evaluation of Upper Limb Function of Chinese Society of Hand Surgery, it was excellent in 28 cases, good in 11 cases and moderate in 7 cases, with the overall excellent and good rate of 84.8%. \u0000 \u0000 \u0000Conclusion \u0000The Reading man flap is a good option for treatment of the small size soft tissu defect in distal fingers with the advantages of simple procedure, high success rate, good appearance and sensory recovery. \u0000 \u0000 \u0000Key words: \u0000Reading man flap; Surgical flap; Soft tissue defect; Finger; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"559-562"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69872024","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":"Repair of large area of soft tissue defect of calf by the retrograde anterolateral thigh flap with single high cutaneous perforator","authors":"Zhiyu Hu, Chao-feng Xing, Y. Xiong, Li Song, K. Song, Yong Zhang, Ruifu Yang, Shi-min Li","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.006","url":null,"abstract":"Objective \u0000To explore the clinical effect of repairing the large area of soft tissue defect of the calf by the retrograde anterolateral thigh flap with single high cutaneous perforator. \u0000 \u0000 \u0000Methods \u0000From January, 2014 to July, 2017, 9 cases of large area of soft tissue defects were repaired by the retrograde anterolateral thigh flap with single high cutaneous perforator. There were 7 males and 2 females, aged 24-48 years. Soft tissue defects area of the calf was 10.0 cm×7.0 cm to 35.0 cm×15.0 cm, including skin grafting and skin stretch to repair the area. The perforating point of the high cutaneous artery branches was designed at the proximal end of the flap, which was used as the single nutrient vessel of the flap. The rotation point of the flap was moved upward to the proximal thigh, which not only increased the blood supply of the flap, but also made the flap repair range to the distal calf. The flap range was 15.0 cm×10.0 cm to 22.0 cm×12.0 cm. \u0000 \u0000 \u0000Results \u0000All flaps were cut smoothly, and no vascular crisis occurred. All flaps survived smoothly. All patients were followed-up for 6-12 months. The appearance of flaps was plump, slightly bloated, and their color was similar to the recipient area. The texture was soft, and no active disorder in the donor site. \u0000 \u0000 \u0000Conclusion \u0000The retrograde anterolateral thigh flap with single high cutaneous perforator can be designed at a high rotation point. By increasing the number and caliber of the anastomotic branch between the pedicle and lateral superior genicular artery, the blood supply and reflux of flap can be improved, and the survival rate is not affected. Compared with the traditional anterolateral thigh flap, it has great advantages. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh flap; High cutaneous perforator; Lower leg; Soft tissue defect","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"544-547"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42488923","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}