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Objective To investigate the effectiveness of preoperative 3D-CTA in assisting the preparation of free thinned anterolateral thigh lobulated perforator flap with nerve in repairing soft tissue defect of limb. Methods Between February, 2010 and May, 2018, free super-thin anterolateral thigh lobulated perforator flap with nerve was transferred to repair soft tissue defect of limbs in 11 cases. There were 8 males and 3 females with an average age of 35 (range, 22-56) years.The defect area was 8.0 cm×11.0 cm-9.0 cm×23.0 cm. Preoperation CT scan of the free flap donor site was performed to obtain 3D images of the region with arterial blood supply by digital 3D reconstruction CT, and to determine the origin, direction, classification, length, diameter and the position of pedicle perforator.Postopera鄄tive regular followed-up was carried according to the Upper Limb Function Evaluation Trial Standards of Chinese Medical Association of Hand Surgery and Enneking Evaluation System. Results All 11 flaps survived. No vascular crisis happened.All 11 cases were followed-up for 3 to 12 (average, 5) months.The flaps were supple and elastic with near normal color.There was no bulkiness.Sensory function was recovered well and two point discrimination was 3.0-6.0 mm. According to the Upper Limb Function Evaluation of Upper Limb of Chinese Medical Association of Hand Surgery, the results were excellent in 1 case, good in 3 cases and fair in 1 case.The Enneking system was used to as鄄sesse the lower limbs recovery.The average score was 21, an average of 70% of limb function restored. Conclusion The free super-thin anterolateral thigh lobulated perforator flap with nerve offers advantages to the traditional antero鄄lateral thigh flap. The survived flaps are ideal in terms of covering limb defects and restoring functions. Preoperative 3D-CTA in the anterolateral thigh perforator flap transplantation is an accurate and useful method.It helps a safer and successful operation with optimal outcome.
ABSTRACT
Objective@#To investigate the effectiveness of preoperative 3D-CTA in assisting the preparation of free thinned anterolateral thigh lobulated perforator flap with nerve in repairing soft tissue defect of limb.@*Methods@#Between February, 2010 and May, 2018, free super-thin anterolateral thigh lobulated perforator flap with nerve was transferred to repair soft tissue defect of limbs in 11 cases. There were 8 males and 3 females with an average age of 35 (range, 22-56) years. The defect area was 8.0 cm×11.0 cm-9.0 cm×23.0 cm. Preoperation CT scan of the free flap donor site was performed to obtain 3D images of the region with arterial blood supply by digital 3D reconstruction CT, and to determine the origin, direction, classification, length, diameter and the position of pedicle perforator. Postoperative regular followed-up was carried according to the Upper Limb Function Evaluation Trial Standards of Chinese Medical Association of Hand Surgery and Enneking Evaluation System.@*Results@#All 11 flaps survived. No vascular crisis happened. All 11 cases were followed-up for 3 to 12 (average, 5) months. The flaps were supple and elastic with near normal color. There was no bulkiness. Sensory function was recovered well and two point discrimination was 3.0-6.0 mm. According to the Upper Limb Function Evaluation of Upper Limb of Chinese Medical Association of Hand Surgery, the results were excellent in 1 case, good in 3 cases and fair in 1 case. The Enneking system was used to assesse the lower limbs recovery. The average score was 21, an average of 70% of limb function restored.@*Conclusion@#The free super-thin anterolateral thigh lobulated perforator flap with nerve offers advantages to the traditional anterolateral thigh flap. The survived flaps are ideal in terms of covering limb defects and restoring functions. Preoperative 3D-CTA in the anterolateral thigh perforator flap transplantation is an accurate and useful method. It helps a safer and successful operation with optimal outcome.
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Objective@#To investigate the therapeutic effect of fibular head composite flap in repairing the bone and skin defect of radiocarpal joint.@*Methods@#From Aug.2009 to Dec.2016, 9 cases with bone and skin defects at radiocarpal joint were reconstructed with fibular head composite flaps pedicled with lateral inferior genicular vascular bundle. The skin defect size was (3-7) cm×(5-10) cm.The joint function was assessed by the Gartland-Werley standard score.@*Results@#All 9 patients were followed up for 6 months to 3 years, with an average of 18 months.Primary wound healing was achieved in all cases without infection.Bony union of the transplanted fibular head was observed .The range of motion (ROM) of the wrist joint and forearm was assessed as following: the mean extension range of motion was 32.9° (range 29°-41°), flexion 24.5° (range 18°-33°), pronation 75° (range 56°-83°)and supination 65.4° (range 40°-78°). The average grip strength was 78% of that on the healthy side. Mayo wrist score was 85 on average, ranging from 58 to 91.By the Gartland-Werley standard score, the wrist function was rated as excellent in 3 case, good in 5 cases and fair in 1 case, with an excellent to good rate of 88.9%.All patients could cope with daily life and work, with good wrist stability and no motion-related pain.@*Conclusions@#The fibular head composite tissue flap has a good therapeutic effect in repairing the bone and skin defect of radiocarpal joint.
ABSTRACT
Angiopoietin is a novel angiogenesis related molecule. To investigate its roles in tumor angiogenesis and metastasis,angiopoietin 1 gene was obtained from human placental tissue by reverse transcription polymerase chain reaction (RT PCR). The sense, antisense eukaryotic expression vector pcDNA3.1/hangiopoietin1(+), antisense eakaryotic expression vector pcDNA3.1/hangiopoietin1(-), and prokaryotic expression vector pRSETC hangiopoietin1 were successfully constructed by directional cloning the target gene into pcDNA3.1 V5 His C and pRSET C vectors, respectively. This lays good foundation for further study on the roles of angiopoietin 1 in angiogenesis in tumors of the digestive tract.