ABSTRACT
Objective:To explore the method and effect of aesthetic reconstruction of distal segment of finger with modified second toe nail flap while retains the full length of the second toe.Methods:From April 2018 to June 2020, 16 patients with degloving injury of distal segment of fingers were treated. The patients were 11 males and 5 females aged 18 to 45 years in an average of 29 years. All injuries were degloving injury of the distal segment of finger, including 5 index fingers, 7 middle fingers, 3 ring fingers and 1 little finger. The time from injury to operation was 0.5-3.0 hours, with an average of 1.5 hours. The second toe nail flap was used for the reconstruction. After the dorsal flap of the second toe was rotated to the plantar side of the foot, the donor site defect was repaired by a skin graft. The regular follow up reviews were carried out.Results:All 16 flaps survived except 1 flap had necrosis and underwent toe amputation of the distal segment of the second toe. All patients entered follow-up for 4-12 months, with an average of 5.7 months. The blood supply of all flaps was good. After the flaps having atrophied, they were equivalent to the diameter of the body of normal fingers with the TPD at 6.5(4-10) mm; All patients returned to work. According to the Evaluation Standard of Upper Limb Function of Chinese Hand Surgery Society, 13 cases were graded as excellent, 2 were good and 1 was fair.Conclusion:The techniques of modified second toe toenail flap in aesthetic reconstruction of the distal segment of a finger can effectively restore the length and aesthetic appearance of the affected finger, without sacrificing the donor toe. Clinical application of it should be promoted.
ABSTRACT
Objective:To explore a surgical procedure of reconstruction finger pulp defect with free toes plantar flap with vascular anastomosis of toe-finger artery and plantar-palmar vein of finger.Methods:From April, 2018 to November, 2019, 15 patients with finger pulp defect were repaired by transplantation of the second toe pulp. In the procedure, the plantar vein of the toe and palmar vein of the finger were anastomosed. The artery and nerve of the toe and finger were anastomosed. The flap size was 0.8 cm×0.5 cm-1.0 cm×1.2 cm. The donor site was primary closed without deformity and other complication.Results:All flaps survived without vascular crisis. The mean followed-up period was 5.7 (range 3-9) months. The flaps had good blood flow, soft texture and good elasticity. Three months after surgery, touch sensation was partly recovered in some patients, and while pain was partly recovered in some patients 4-6 months after surgery. There was no deformity and other complication in the donor site. The donor sites of the foot had good appearance and normal walking function.Conclusion:The free toe plantar flap anastomosed with palmar vein can repair the digital pulp defect without dissecting the dorsal vein of digital (toe), and the donor sites can be primary sutured without deformity and other complications. The surgery operation is simple with satisfactory clinical effect.
ABSTRACT
Based on the social background of increasingly serious aging of the population and the growth of chronic diseases,the paper introduces the mode of Connected Health (cHealth),analyzes the differences between cHealth and Mobile Health (mHealth) as well as the advantages of cHealth,introduces the application of cHealth in contemporary society,and discusses the challenges of cHealth,including the optimization of sensing strategy,creation of data integration,analysis on the new mode,optimization of feedback strategy and development of new health insurance modes.
ABSTRACT
Objective To improve the utilization ratio of operating room in Affiliated Hospital of Central South Uni-versity Xiangya Medical School by providing more comprehensive reference data for the design of surgical time pre-diction and dispatch system. Methods A questionnaire was designed according to the review of literature and consul-tation of experts for investigating the surgical time influencing factors. The surgical time influencing factors were ana-lyzed by stratified sampling. Results The surgeons-related factor was the highest influencing factor while the pa-tients themselves-related factor was the lowest influencing factor in the 2-dimensional factors. The selected 38 1-dimensional factors could affect the operating time with their mean influencing value>2 . 45 . The recognition of sur-gical time influencing factors was different in different operating rooms. Conclusion There are a variety of surgical time influencing factors. However, the surgeons-related factor is the highest influencing factor. The cognition of anesthesia-related factors and surgeons-related factors differs in different operating rooms.