Repair of diabetic foot ulcer wound by anterolateral thigh chimeric perforator flap / 中华显微外科杂志

Objective:To investigate the clinical effect of the anterolateral thigh perforator chimeric flap in the treatment of the wound of diabetic foot ulcer (DFU) .Methods:From January, 2018 to December, 2019, 14 cases wound of DFU of type II diabetic were treated by anterolateral thigh chimeric perforator flap. The patients were 10 males and 4 females, at 49 to 58 years old. Of the 14 patients, 10 with simple peripheral neuropathy, 4 with peripheral neuropathy complicated with vascular disease, and none with single vascular disease. With strict control of patients' blood glucose, antibiotics blended bone cement was applied or filled onto grade 2 or higher grade Wagner's DFU after debridement. In addition, the anterolateral thigh chimeric perforator flap was transferred 2 to 3 weeks later. The size of flap was 8 cm×3 cm-27 cm×7 cm. Regular followed-up were made after surgery.Results:Thirteen flaps survived in one stage after surgery. The other 1 flap had venous vascular crisis, and survived completely after active exploration. The patients were followed-up for 6-12 months. All the flaps survived well in good shape and texture. The donor and recipient areas healed well. The functional recoveries of the DF were satisfactory.Conclusion:Application of anterolateral thigh perforator chimeric flap in repair of the refractory wound of DF achieves a good clinical outcome and effectively improves the life quality of patients.

Percutaneous hepatocholangiostomy in treatment of recurrence hepatobiliary stones / 中国医师进修杂志

Objective To explore the potential predominance and value of percutaneous hepatocholangiostomy (PCH) in treatment of recurrence hepatobiliary stones (RHS). Methods Seventeen cases with RHS were treated by PCH from February 2001 to October 2005, which was an improved technology of percutaneous transhepatic cholangioscopy (PTCS) and made reference to the methods of percutaneous nephrostomy (PCN). Results Seventeen cases were successfully treated. The average blood loss was 40 ml (ranging from 15 to 100 ml), and stones were removed completely in 88.2% (15/17). The average hospital stay was 14 (ranging from 10 to 59) days. No one required postoperative analgesic. No postoperative bleeding and biliary leakage were found. Conclusions PCH has significant advantages of minimal invasion, little blood loss, less pain, less complications and quick recovery in the treatment of RHS.

Mini-endoscopes sympathectomy for hyperhidrosis palmaris / 中国医师进修杂志

Objective To explore the feasibility of sympathectomy for hyperhidrosis palmaris using mini-endoscopic instruments and two ports approaches.Methods Thirty-one patients underwent sympathectomy using 3 or 5 mm mini-endoscopic through the cannula introduced at the fourth intercostal space and a 2.5 mm Hook-electrode through the cannula introduced at the second intercostal space on the anterior axillary line,without pleural drainage.Results All cases were successful without major intraoperative incident and postoperative complications,such as wound infection and bleeding.No analgesic was used.The average time of operations was(25?8) minutes each side.Hyperhidrosis palmaris was disappeared in 29 cases(93.5%),reduced in 2 cases(6.5%) postoperatively.Conclusions Sympathectomy using mini-endoscopic instruments and two ports approaches is safe,feasible and effective with good cosmetic result.