Application of serial tightening of reserved suture threads in delayed incision closure / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical outcomes of serial tightening of reserved suture threads in delayed incision closure.</p><p><b>METHODS</b>From January 2005 to June 2013, 67 patients with delayed incision closure were treated with serial tightening of reserved suture threads. There were 37 males and 30 females, with an average age of 40 years old (ranged from 12 to 75 years old). Among them, 36 patients suffering from leg or forearm double fractures had the incision difficult to those primarily due to high tension or mergency; 13 patients had open wound which lasted for more than routine time for debridement and closure; 9 patients had wound infection; 9 patients had decompression incisions owing to compartment syndrome. The No. 4 suture thread was used to sew up the incision, and the 4 to 6 cm long thread was reserved at two ends of each thread. The reserved thread was tightened gradually from 2 to 4 days after operation according to conditions of swelling relieving. Finally, the reserved thread was not tied until the incision was completely closed.</p><p><b>RESULTS</b>After operation, the reserved threads were tightened and tied for 1 time in 6 patients, 2 times in 23 patients, 3 times in 27 patients, 4 times in 11 patients. Postoperative closure time ranged from 3 to 9 days, with an average of 6.2 days. All the incisions got delayed primary healing.</p><p><b>CONCLUSION</b>The method of serial tightening of reserved suture threads to close delayed incision closure avoids a second operation, which is simple and obtains a fine result.</p>

The application of Delphi method in improving the score table for the hygienic quantifying and classification of hotels / 中华预防医学杂志

<p><b>OBJECTIVE</b>By means of Delphi method and expert panel consultations, to choose suitable indicators and improve the score table for classifying the hygienic condition of hotels so that it can be widely used at nationwide.</p><p><b>METHODS</b>A two-round Delphi consultation was held to choose suitable indicators among 78 experts from 18 provinces, municipalities and autonomous regions. The suitable indicators were selected according to the importance recognized by experts.</p><p><b>RESULTS</b>The average length of service in public health of the experts was (21.08 +/- 5.78) years and the average coefficient of experts' authorities C(r) was 0.89 +/- 0.07. The response rates of the two-round consultation were 98.72% (77/78) and 100.00% (77/77). The average feedback time were (8.49 +/- 4.48) d, (5.86 +/- 2.28) d, and the difference between two rounds was statistically significant (t = 4.60, P < 0.01). Kendall's coefficient were 0.26 (chi(2) = 723.63, P < 0.01), 0.32 (chi(2) = 635.65, P < 0.01) and opinions among experts became consistent. The score table for the hygienic quantifying and classification of hotels was composed of three first-class indicators (hygienic management, hygienic facilities and hygienic practices) and 36 second-class indicators. The weight coefficients of the three first-class indicators were 0.35, 0.34, 0.31.</p><p><b>CONCLUSION</b>Delphi method might be used in a large-scale consultation among experts and be propitious to improve the score table for the hygienic quantifying and classification.</p>

Clinical application of free upper limb lateral bone-skin flap in hand surgery field / 中华显微外科杂志

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.